MEDICARE: LASHONDA JENNINGS

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1881314540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LASHONDA JENNINGS

Provider Business Mailing Address
First Line	:	9414 W SHERIDAN ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85037-4335
Country	:	US
Telephone Number	:	317-490-2846
Fax Number	:

Provider Business Practice Location Address
First Line	:	9414 W SHERIDAN ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85037-4335
Country	:	US
Telephone Number	:	317-490-2846
Fax Number	:

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

Provider Enumeration Date	:	09/01/2022
Last Update Date	:	09/01/2022

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Directions to “ LASHONDA JENNINGS ” Practice Location

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