Provider Demographics
NPI:1891243838
Name:JONES, ADDIE CLAIRE (RDN)
Entity type:Individual
Prefix:
First Name:ADDIE
Middle Name:CLAIRE
Last Name:JONES
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 MIDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-2325
Mailing Address - Country:US
Mailing Address - Phone:704-502-8373
Mailing Address - Fax:202-939-2576
Practice Address - Street 1:1804 MIDWOOD DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-2325
Practice Address - Country:US
Practice Address - Phone:704-502-8373
Practice Address - Fax:202-939-2576
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI100000844133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered