Provider Demographics
NPI:1801441316
Name:JONES, BRENDA G
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:G
Last Name:JONES
Suffix:
Gender:F
Credentials:
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 144
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NJ
Mailing Address - Zip Code:25788
Mailing Address - Country:US
Mailing Address - Phone:252-425-5558
Mailing Address - Fax:
Practice Address - Street 1:4926 WINDY HILL DR STE A
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5182
Practice Address - Country:US
Practice Address - Phone:252-425-5558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-02
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YP1600X, 104100000X, 253Z00000X, 372600000X, 374U00000X, 376K00000X
171M00000X, 251B00000X, 251G00000X, 251V00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management
No251G00000XAgenciesHospice Care, Community Based
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide