Provider Demographics
NPI:1851113328
Name:JHONS, SHANITHIA
Entity type:Individual
Prefix:MS
First Name:SHANITHIA
Middle Name:
Last Name:JHONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 E 13 MILE RD APT 201
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-5016
Mailing Address - Country:US
Mailing Address - Phone:313-523-0151
Mailing Address - Fax:
Practice Address - Street 1:1595 E 13 MILE RD APT 201
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-5016
Practice Address - Country:US
Practice Address - Phone:313-523-0151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker