Healthcare Provider Details

I. General information

NPI: 1306303698
Provider Name (Legal Business Name): JASMINE JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2417 NEFF RD
DAYTON OH
45414-5024
US

IV. Provider business mailing address

2417 NEFF RD
DAYTON OH
45414-5024
US

V. Phone/Fax

Practice location:
  • Phone: 704-258-6288
  • Fax:
Mailing address:
  • Phone: 704-258-6288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number401486390213
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number184003
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: