Provider Demographics
NPI:1730805912
Name:JONES, JUANITA ELAINE
Entity type:Individual
Prefix:
First Name:JUANITA
Middle Name:ELAINE
Last Name:JONES
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 1:639 ELLEN WILSON PL SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4238
Mailing Address - Country:US
Mailing Address - Phone:202-657-8891
Mailing Address - Fax:
Practice Address - Street 1:1000 6TH ST SW APT 203
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-2653
Practice Address - Country:US
Practice Address - Phone:202-469-2172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant