Provider Demographics
NPI:1699370296
Name:JONES, SHERMICKA RENA (MT)
Entity Type:Individual
Prefix:MS
First Name:SHERMICKA
Middle Name:RENA
Last Name:JONES
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 PROFESSIONAL CT STE 101
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-8348
Mailing Address - Country:US
Mailing Address - Phone:919-727-1999
Mailing Address - Fax:
Practice Address - Street 1:109 PROFESSIONAL CT STE 101
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-8348
Practice Address - Country:US
Practice Address - Phone:919-727-1999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11937225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist