Provider Information for 1013670819
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SHANIKA KATARA JONES
Sex: Female
NPI: 1013670819
Last Updated: 2024-12-10
Certification Date: 2024-12-10
Certification Date: 2024-12-10
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1013670819 | ||||||||||||
| Enumeration Date | 2021-10-19 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1169 FROMAGE CIR E JACKSONVILLE, FL 32225-4499 United States Phone: 912-484-6599 | Fax: | ||||||||||||
| Primary Practice Address | 1169 FROMAGE CIR E JACKSONVILLE, FL 32225-4499 United States Phone: 912-484-6599 | Fax: | ||||||||||||
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