Provider Demographics
NPI:1568043180
Name:STONER, JAMELIA SHEREE (CNA/PROGRAM MANAGER)
Entity type:Individual
Prefix:MS
First Name:JAMELIA
Middle Name:SHEREE
Last Name:STONER
Suffix:
Gender:F
Credentials:CNA/PROGRAM MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4147 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40211-2559
Mailing Address - Country:US
Mailing Address - Phone:702-273-7228
Mailing Address - Fax:
Practice Address - Street 1:9900 VIEUX CARRE DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-3211
Practice Address - Country:US
Practice Address - Phone:702-273-7228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY50115182376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide