Healthcare Provider Details

I. General information

NPI: 1235914631
Provider Name (Legal Business Name): RENATA JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 08/25/2023
Certification Date: 08/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 WASHINGTON AVE
BATON ROUGE LA
70802-2880
US

IV. Provider business mailing address

2132 GAUSE BLVD E STE 18
SLIDELL LA
70461-4243
US

V. Phone/Fax

Practice location:
  • Phone: 225-221-0559
  • Fax:
Mailing address:
  • Phone: 225-434-4412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number009230419
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number009230419
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: