MEDICARE: ADDIE CLAIRE JONES RDN

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	133V00000X	Registered Dietitian	DI100000844	DC

General Provider Information

NPI Number	:	1891243838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADDIE CLAIRE JONES RDN

Provider Business Mailing Address
First Line	:	1804 MIDWOOD DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-2325
Country	:	US
Telephone Number	:	704-502-8373
Fax Number	:	202-939-2576

Provider Business Practice Location Address
First Line	:	1804 MIDWOOD DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-2325
Country	:	US
Telephone Number	:	704-502-8373
Fax Number	:	202-939-2576

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

Provider Enumeration Date	:	09/20/2016
Last Update Date	:	10/21/2020

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