Provider Demographics
NPI:1609685239
Name:DANDENEAU- JONES, KRISTYN ASHLEY
Entity type:Individual
Prefix:
First Name:KRISTYN
Middle Name:ASHLEY
Last Name:DANDENEAU- 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 1:3706 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-3125
Mailing Address - Country:US
Mailing Address - Phone:531-299-1720
Mailing Address - Fax:
Practice Address - Street 1:3706 MAPLE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-3125
Practice Address - Country:US
Practice Address - Phone:531-299-1720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant