Healthcare Provider Details

I. General information

NPI: 1871387456
Provider Name (Legal Business Name): LAKISHA SHANETTE JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 05/01/2026
Certification Date: 04/08/2025
Deactivation Date: 08/20/2025
Reactivation Date: 05/01/2026

III. Provider practice location address

1320 N HAMILTON ST STE 105
HIGH POINT NC
27262-2731
US

IV. Provider business mailing address

1320 N HAMILTON ST STE 105
HIGH POINT NC
27262-2731
US

V. Phone/Fax

Practice location:
  • Phone: 336-807-6469
  • Fax:
Mailing address:
  • Phone: 336-807-6469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: