Provider Demographics
NPI:1730760638
Name:JEFFERSON-JONES, SURNITA LAWON
Entity type:Individual
Prefix:
First Name:SURNITA
Middle Name:LAWON
Last Name:JEFFERSON-JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 HARTFORD ST SE APT 303
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-7964
Mailing Address - Country:US
Mailing Address - Phone:202-889-2714
Mailing Address - Fax:
Practice Address - Street 1:206 BLAIR RD APT 103
Practice Address - Street 2:
Practice Address - City:INDIAN HEAD
Practice Address - State:MD
Practice Address - Zip Code:20640-1974
Practice Address - Country:US
Practice Address - Phone:301-848-0676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant