Provider Demographics
NPI:1336286749
Name:JONES, BRENDA SUE (LPN)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:SUE
Last Name:JONES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 KNOB RD
Mailing Address - Street 2:
Mailing Address - City:RUTLEDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37861-4705
Mailing Address - Country:US
Mailing Address - Phone:865-828-4587
Mailing Address - Fax:
Practice Address - Street 1:185 JUSTICE CENTER DR
Practice Address - Street 2:
Practice Address - City:RUTLEDGE
Practice Address - State:TN
Practice Address - Zip Code:37861
Practice Address - Country:US
Practice Address - Phone:865-828-5247
Practice Address - Fax:865-828-3594
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPN0000065457164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse