Provider Demographics
NPI:1487938692
Name:JONES, KENNASHA JENEDE (CPM, LM)
Entity type:Individual
Prefix:MS
First Name:KENNASHA
Middle Name:JENEDE
Last Name:JONES
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-8644
Mailing Address - Country:US
Mailing Address - Phone:503-317-3414
Mailing Address - Fax:
Practice Address - Street 1:3512 BRENTWOOD DR
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-8644
Practice Address - Country:US
Practice Address - Phone:503-317-3414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99114176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife