Provider Demographics
NPI:1598585424
Name:JONES, BRANDI RACHELLE
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:RACHELLE
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 1:3540 SAINT NICK ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-7595
Mailing Address - Country:US
Mailing Address - Phone:337-563-8490
Mailing Address - Fax:
Practice Address - Street 1:3540 SAINT NICK ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-7595
Practice Address - Country:US
Practice Address - Phone:337-563-8490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)