Provider Demographics
NPI:1215409388
Name:JONES, RENEE
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name: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 1:399 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:EDGARD
Mailing Address - State:LA
Mailing Address - Zip Code:70049-2331
Mailing Address - Country:US
Mailing Address - Phone:985-294-1148
Mailing Address - Fax:
Practice Address - Street 1:399 E 6TH ST
Practice Address - Street 2:
Practice Address - City:EDGARD
Practice Address - State:LA
Practice Address - Zip Code:70049-2331
Practice Address - Country:US
Practice Address - Phone:985-294-1148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-29
Last Update Date:2018-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver