Healthcare Provider Details

I. General information

NPI: 1225963598
Provider Name (Legal Business Name): RAUSHANA IMAN JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9540 MARLBORO PIKE UNIT 101
UPPER MARLBORO MD
20772-3774
US

IV. Provider business mailing address

9540 MARLBORO PIKE UNIT 101
UPPER MARLBORO MD
20772-3774
US

V. Phone/Fax

Practice location:
  • Phone: 301-578-6075
  • Fax:
Mailing address:
  • Phone: 240-429-1396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: