Provider Demographics
NPI:1811546278
Name:JONES, NERECA CAROL (HOUSE WIFE)
Entity Type:Individual
Prefix:MRS
First Name:NERECA
Middle Name:CAROL
Last Name:JONES
Suffix:
Gender:F
Credentials:HOUSE WIFE
Other - Prefix:
Other - First Name:NERECA
Other - Middle Name:CAROL
Other - Last Name:BICKEMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:HOUSE WIFE
Mailing Address - Street 1:5011 COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75215
Mailing Address - Country:US
Mailing Address - Phone:214-245-2423
Mailing Address - Fax:
Practice Address - Street 1:5011 COLONIAL AVENUE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215
Practice Address - Country:US
Practice Address - Phone:214-565-8377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant