Provider Demographics
NPI:1821411562
Name:JONES, RENEA D (NP-C)
Entity Type:Individual
Prefix:
First Name:RENEA
Middle Name:D
Last Name:JONES
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 837
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-0837
Mailing Address - Country:US
Mailing Address - Phone:910-383-1500
Mailing Address - Fax:910-383-1504
Practice Address - Street 1:51 LEE DRIVE
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-8249
Practice Address - Country:US
Practice Address - Phone:910-383-1500
Practice Address - Fax:910-383-1504
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC276144363LP2300X, 363LF0000X
OHCOA15469363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner