Provider Demographics
NPI:1699163840
Name:JONES, CHARLOTTE LUCY WYNNE (AG-ACNP)
Entity type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:LUCY WYNNE
Last Name:JONES
Suffix:
Gender:F
Credentials:AG-ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 N CALVERT ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-5813
Mailing Address - Country:US
Mailing Address - Phone:202-906-9833
Mailing Address - Fax:
Practice Address - Street 1:2 LOWER RAGSDALE DR STE 160
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5840
Practice Address - Country:US
Practice Address - Phone:202-906-9833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-22
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR191678163WC0200X, 363LA2100X
CANP95011751363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine