Provider Demographics
NPI:1932446952
Name:JONES, MEKAEL (FNP, PMHNP)
Entity Type:Individual
Prefix:
First Name:MEKAEL
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11119 GALAXY HUNTER DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-5269
Mailing Address - Country:US
Mailing Address - Phone:208-705-0943
Mailing Address - Fax:
Practice Address - Street 1:1465 KELLY JOHNSON BLVD STE 320
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3947
Practice Address - Country:US
Practice Address - Phone:719-495-3359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0004304-C-NP363LF0000X
COAPN.0998288-NP363LF0000X
UT5328075-4405363LF0000X
CO2023129917363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0107352OtherCOLORADO RXN LICENSE
UT5328075-4405OtherUTAH NP LICENSE
COPMHNPOtherANCC
CO0998288OtherCOLORADO APRN LICENSE
CO9000228029Medicaid
COF0614930OtherFNP