Ms Jackie Lynn Jones, CRNP | |
6105 Pinehurst Rd, Baltimore, MD 21212-2547 | |
(443) 388-9627 | |
Not Available |
Full Name | Ms Jackie Lynn Jones |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Gerontology |
Location | 6105 Pinehurst Rd, Baltimore, Maryland |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1861545881 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LG0600X | Nurse Practitioner - Gerontology | R149792 (Maryland) | Primary |
Entity Name | Five Star Physician Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083654479 PECOS PAC ID: 3779572862 Enrollment ID: O20040528000495 |
Mailing Address | Practice Location Address |
---|---|
Ms Jackie Lynn Jones, CRNP 6105 Pinehurst Rd, Baltimore, MD 21212-2547 Ph: (443) 388-9627 | Ms Jackie Lynn Jones, CRNP 6105 Pinehurst Rd, Baltimore, MD 21212-2547 Ph: (443) 388-9627 |
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