Provider Demographics
NPI:1336518265
Name:JONES, EUDORA
Entity type:Individual
Prefix:
First Name:EUDORA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 E MAIN STREET
Mailing Address - Street 2:2ND AND 3RD FLOOR (PRIVATE OFFICE 303)
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3587 BUCKLEY DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:MD
Practice Address - Zip Code:21755-8255
Practice Address - Country:US
Practice Address - Phone:301-339-4091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR173104163WP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health