Provider Demographics
NPI:1548400237
Name:JONES, SIMONE T
Entity Type:Individual
Prefix:MS
First Name:SIMONE
Middle Name:T
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SIMONE
Other - Middle Name:T
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7626 EASTBOURNE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-3005
Mailing Address - Country:US
Mailing Address - Phone:704-649-0190
Mailing Address - Fax:704-532-8956
Practice Address - Street 1:7626 EASTBOURNE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-3005
Practice Address - Country:US
Practice Address - Phone:704-649-0190
Practice Address - Fax:704-532-8956
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker