Provider Demographics
NPI:1629048384
Name:JONES, KAITLYN ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8415 BELLONA LN
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2055
Mailing Address - Country:US
Mailing Address - Phone:410-821-7775
Mailing Address - Fax:410-821-1320
Practice Address - Street 1:8415 BELLONA LN
Practice Address - Street 2:SUITE 201
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-2055
Practice Address - Country:US
Practice Address - Phone:410-821-7775
Practice Address - Fax:410-821-1320
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR114758363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health