Healthcare Provider Details

I. General information

NPI: 1851295547
Provider Name (Legal Business Name): KATINA NICHELLE JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E WENDOVER AVE STE 100
GREENSBORO NC
27401-1233
US

IV. Provider business mailing address

4388 FEDERAL DR
GREENSBORO NC
27410-8115
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-7285
  • Fax:
Mailing address:
  • Phone: 336-832-7285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number13507
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: