MEDICARE: BRANDI C JASPER-JONES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747A0650X	Attendant Care Provider

General Provider Information

NPI Number	:	1134081623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI C JASPER-JONES

Provider Business Mailing Address
First Line	:	1501 SAN PEDRO DR SE # 128
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-5153
Country	:	US
Telephone Number	:	931-436-1036
Fax Number	:

Provider Business Practice Location Address
First Line	:	3308 OASIS SPRINGS RD NE
Second Line	:
City	:	RIO RANCHO
State	:	NM
Zip	:	87144-2579
Country	:	US
Telephone Number	:	931-436-1036
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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