Provider Demographics
NPI:1588241103
Name:JONES, PAQUITA
Entity type:Individual
Prefix:
First Name:PAQUITA
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 1:7567 SAM HALL RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-7709
Mailing Address - Country:US
Mailing Address - Phone:919-691-3870
Mailing Address - Fax:984-888-0182
Practice Address - Street 1:801 GILBERT ST STE 218
Practice Address - Street 2:SUITE 218
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-3581
Practice Address - Country:US
Practice Address - Phone:919-691-3870
Practice Address - Fax:984-888-0182
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-28
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC5882253Z00000X, 2278H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2518815Medicaid