MEDICARE: MRS. REBECCA MARIE JONES PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN286305	GA

General Provider Information

NPI Number	:	1598564056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA MARIE JONES PMHNP-BC

Provider Business Mailing Address
First Line	:	1480 CHANDLER RD
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30045-6514
Country	:	US
Telephone Number	:	706-352-1156
Fax Number	:

Provider Business Practice Location Address
First Line	:	8025 MAJORS RD
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30041-7056
Country	:	US
Telephone Number	:	844-407-2680
Fax Number	:

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

Provider Enumeration Date	:	03/10/2025
Last Update Date	:	06/19/2025

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