Provider Demographics
NPI:1588348353
Name:JONES, KAYLAH TANEAL (RN)
Entity type:Individual
Prefix:
First Name:KAYLAH
Middle Name:TANEAL
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 S HANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-5934
Mailing Address - Country:US
Mailing Address - Phone:716-489-6334
Mailing Address - Fax:
Practice Address - Street 1:165 S HANFORD AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-5934
Practice Address - Country:US
Practice Address - Phone:716-489-6334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY772430163WH0200X, 163WD1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WH0200XNursing Service ProvidersRegistered NurseHome Health