MEDICARE: MS. BRENDA G JONES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	101YP1600X	Pastoral Counselor	NC
2	104100000X	Social Worker	NC
3	171M00000X	Case Manager/Care Coordinator
4	251B00000X	Case Management Agency
5	251G00000X	Community Based Hospice Care Agency
6	251V00000X	Voluntary or Charitable Agency
7	253Z00000X	In Home Supportive Care Agency	NC
8	372600000X	Adult Companion	NC
9	374U00000X	Home Health Aide	NC
10	376K00000X	Nurse's Aide	NC
11	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1801441316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRENDA G JONES

Provider Business Mailing Address
First Line	:	PO BOX 144
Second Line	:
City	:	WAKE FOREST
State	:	NJ
Zip	:	25788
Country	:	US
Telephone Number	:	252-425-5558
Fax Number	:

Provider Business Practice Location Address
First Line	:	4926 WINDY HILL DR STE A
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-5182
Country	:	US
Telephone Number	:	252-425-5558
Fax Number	:

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

Provider Enumeration Date	:	08/02/2019
Last Update Date	:	09/26/2019

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