Healthcare Provider Details

I. General information

NPI: 1063329209
Provider Name (Legal Business Name): SHAWNA LAURIE JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5180 BLACKMORE RD APT 101
CASPER WY
82609-4376
US

IV. Provider business mailing address

5180 BLACKMORE RD APT 101
CASPER WY
82609-4376
US

V. Phone/Fax

Practice location:
  • Phone: 307-247-0028
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: