Provider Demographics
NPI:1063250678
Name:JONES, ANGELA MARY (CNM)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARY
Last Name:JONES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MARY
Other - Last Name:VALLILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:485 FOLEY ST UNIT 413
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-1270
Mailing Address - Country:US
Mailing Address - Phone:617-501-1882
Mailing Address - Fax:
Practice Address - Street 1:1600 OSGOOD ST STE 2017
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845
Practice Address - Country:US
Practice Address - Phone:978-975-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife