Provider Demographics
NPI:1518198878
Name:JONES, KELLY A (ANP)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:MS
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:PITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:40 GEORGE KARL BLVD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7183
Mailing Address - Country:US
Mailing Address - Phone:716-218-1000
Mailing Address - Fax:716-200-1857
Practice Address - Street 1:40 GEORGE KARL BLVD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7183
Practice Address - Country:US
Practice Address - Phone:716-218-1000
Practice Address - Fax:716-200-1857
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305117363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health