MEDICARE: JASMINE BRIANA JONES R.N.

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	163W00000X	Registered Nurse	255721	NC

General Provider Information

NPI Number	:	1205267382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE BRIANA JONES R.N.

Provider Business Mailing Address
First Line	:	P.O. BOX 531
Second Line	:
City	:	MAYSVILLE
State	:	NC
Zip	:	28555
Country	:	US
Telephone Number	:	910-330-8300
Fax Number	:

Provider Business Practice Location Address
First Line	:	3308 REHOBETH CHURCH RD APT S
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-5038
Country	:	US
Telephone Number	:	910-330-8300
Fax Number	:

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

Provider Enumeration Date	:	11/27/2013
Last Update Date	:	11/27/2013

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