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NPI Code Detail

MEDICARE: MRS. BRANDI LELIA HOLMES JONES PA-C

MEDICARE: MRS. BRANDI LELIA HOLMES JONES PA-C
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
1363A00000XPhysician Assistant0010-05522NC

General Provider Information

NPI Number : 1982094991
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRANDI LELIA HOLMES JONES PA-C
Provider Business Mailing Address
First Line : 2770 LEWISVILLE CLEMMONS RD
Second Line :
City : CLEMMONS
State : NC
Zip : 27012-8716
Country : US
Telephone Number : 336-971-9491
Fax Number :
Provider Business Practice Location Address
First Line : 2770 LEWISVILLE CLEMMONS RD
Second Line :
City : CLEMMONS
State : NC
Zip : 27012-8716
Country : US
Telephone Number : 336-971-9491
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2015
Last Update Date : 09/01/2021

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