Provider Demographics
NPI:1568155018
Name:JONES, BRADLEY CARLYLE (FNP)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:CARLYLE
Last Name:JONES
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MOYE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4169
Mailing Address - Country:US
Mailing Address - Phone:252-752-7133
Mailing Address - Fax:
Practice Address - Street 1:800 MOYE BLVD STE A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4169
Practice Address - Country:US
Practice Address - Phone:252-752-7133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC295924363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care