Provider Demographics
NPI:1992944573
Name:JONES, MELISSA BEAUDET (MSN, CPNP-AC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:BEAUDET
Last Name:JONES
Suffix:
Gender:F
Credentials:MSN, CPNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37214
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3214
Mailing Address - Country:US
Mailing Address - Phone:202-476-6670
Mailing Address - Fax:
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:CARDIAC INTENSIVE CARE UNIT
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:202-476-6670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN 1007853163WC0200X
DCRN1007853363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine