Individual
MS. SHANITA DEANNA JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15335 PEMBROKE AVE, DETROIT, MI 48235-2046
(313) 283-0541
Mailing address
15335 PEMBROKE AVE, DETROIT, MI 48235-2046
(313) 283-0541
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703113185
MI
Other
Enumeration date
02/16/2015
Last updated
02/16/2015
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