Provider Demographics
NPI:1952658718
Name:JONES, BRENDAN MICHAEL (RN)
Entity Type:Individual
Prefix:MR
First Name:BRENDAN
Middle Name:MICHAEL
Last Name:JONES
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:387 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3062
Mailing Address - Country:US
Mailing Address - Phone:541-840-2346
Mailing Address - Fax:
Practice Address - Street 1:385 GUTHRIE ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-3023
Practice Address - Country:US
Practice Address - Phone:541-840-2346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-12
Last Update Date:2012-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201241590RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse