Provider Demographics
NPI:1588475222
Name:JONES, CHANEL ALEXANDRIA
Entity type:Individual
Prefix:
First Name:CHANEL
Middle Name:ALEXANDRIA
Last Name:JONES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 TUDOR CT
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1121
Mailing Address - Country:US
Mailing Address - Phone:631-209-7585
Mailing Address - Fax:
Practice Address - Street 1:4 TUDOR CT
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1121
Practice Address - Country:US
Practice Address - Phone:631-566-0233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula