Provider Demographics
NPI:1194995662
Name:JONES, MICHELE (NP)
Entity type:Individual
Prefix:MISS
First Name:MICHELE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 INNSBRUCK DR
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-2735
Mailing Address - Country:US
Mailing Address - Phone:716-668-7051
Mailing Address - Fax:716-668-7059
Practice Address - Street 1:60 INNSBRUCK DR
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14227-2735
Practice Address - Country:US
Practice Address - Phone:716-668-7051
Practice Address - Fax:716-668-7059
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304792363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health