Provider Demographics
NPI:1982014270
Name:JONES, PAMELA L (RD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 ROCK POINT CIR E
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-4751
Mailing Address - Country:US
Mailing Address - Phone:318-443-3823
Mailing Address - Fax:
Practice Address - Street 1:119 ROCK POINT CIR E
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-4751
Practice Address - Country:US
Practice Address - Phone:318-443-3823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA756133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered