Provider Demographics
NPI:1790703874
Name:JONES, MONICA B (R D, L D)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:B
Last Name:JONES
Suffix:
Gender:F
Credentials:R D, L D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 NEELY RD
Mailing Address - Street 2:
Mailing Address - City:BENTONIA
Mailing Address - State:MS
Mailing Address - Zip Code:39040-9396
Mailing Address - Country:US
Mailing Address - Phone:662-755-1335
Mailing Address - Fax:662-755-1198
Practice Address - Street 1:133 NEELY RD
Practice Address - Street 2:
Practice Address - City:BENTONIA
Practice Address - State:MS
Practice Address - Zip Code:39040-9396
Practice Address - Country:US
Practice Address - Phone:662-755-1335
Practice Address - Fax:662-755-1198
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSD0660133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered