Provider Demographics
NPI:1699917286
Name:KELLY-JONES, MICHELLE ELAINE (RN)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ELAINE
Last Name:KELLY-JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 E 150TH AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-7360
Mailing Address - Country:US
Mailing Address - Phone:303-451-7059
Mailing Address - Fax:
Practice Address - Street 1:200 EXEMPLA CIRCLE
Practice Address - Street 2:EXEMPLA GOOD SMARATIN MEDICAL CENTER
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026
Practice Address - Country:US
Practice Address - Phone:303-689-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO168956163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse