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MISS SHANERICKA RESHONET JONES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
3998 FAIR RIDGE DRIVE, SUITE 320, FAIRFAX, VA 22033-2921
(703) 295-9360
(703) 295-9369
Mailing address
PO BOX 37090, BALTIMORE, MD 21297-3090
(703) 295-9360
(703) 295-9369

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
157231
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
0024171084
VA
367500000X
Certified Registered Nurse Anesthetist
13884
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04870087
MS
05
1511595
TN
01
1730325762
CHAMPUS/HUMANA TRICARE
05
186289001
AR
01
4205212
BLUE CROSS
TN
01
P00711618
RAILROAD MEDICARE
TN
Enumeration date
12/22/2008
Last updated
08/28/2013
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