Provider Demographics
NPI:1124398185
Name:JONES, TESSA L (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:TESSA
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TESSA
Other - Middle Name:L
Other - Last Name:ADELEKAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:420 CRAIN HWY S STE 2
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3657
Mailing Address - Country:US
Mailing Address - Phone:410-582-8170
Mailing Address - Fax:866-401-0775
Practice Address - Street 1:420 CRAIN HWY S STE 2
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3657
Practice Address - Country:US
Practice Address - Phone:410-582-8170
Practice Address - Fax:866-401-0775
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011660363L00000X
MDR224798363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner