Provider Demographics
NPI:1154412393
Name:JONES, KATHLEEN JANE (ANP)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:JANE
Last Name:JONES
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13165 DEANMAR DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20777-9518
Mailing Address - Country:US
Mailing Address - Phone:301-854-0574
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:HEMATOLOGY/ONCOLOGY CLINIC/AMERICA BUILDING
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0003
Practice Address - Country:US
Practice Address - Phone:301-319-2368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN62363363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR064583OtherNURSE PRACTITIONER LICENSE