MEDICARE: MYESHA JONES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172A00000X	Driver	TK097656	OH
2	376J00000X	Homemaker	TK097656	OH

General Provider Information

NPI Number	:	1245108216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYESHA JONES

Provider Business Mailing Address
First Line	:	3675 E 112TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-2534
Country	:	US
Telephone Number	:	216-854-5945
Fax Number	:

Provider Business Practice Location Address
First Line	:	3675 E 112TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-2534
Country	:	US
Telephone Number	:	216-854-5945
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2025
Last Update Date	:	10/29/2025

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Directions to “ MYESHA JONES ” Practice Location

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