Provider Demographics
NPI:1437634540
Name:JONES, MICHAELA SEWARD (NP)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:SEWARD
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 DEVINE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-2222
Mailing Address - Country:US
Mailing Address - Phone:203-495-2410
Mailing Address - Fax:
Practice Address - Street 1:6 DEVINE ST STE 3
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-2222
Practice Address - Country:US
Practice Address - Phone:203-495-2410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11469363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology