Individual
MRS. BONITA NICOLE JAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., R.D.
Contact information
Practice address
117 SOUTH 11TH AVENUE, LAUREL, MS 39440-4312
(601) 425-3033
(601) 422-0431
Mailing address
P.O. BOX 4361, LAUREL, MS 39441-4361
(601) 425-3033
(601) 422-0431
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1067839
MS
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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