Provider Demographics
NPI:1265782049
Name:JONES, MELISSA ANN (WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 OAK HOLLOW LANE
Mailing Address - Street 2:
Mailing Address - City:COMBINE
Mailing Address - State:TX
Mailing Address - Zip Code:75159
Mailing Address - Country:US
Mailing Address - Phone:214-534-5631
Mailing Address - Fax:
Practice Address - Street 1:1005 OAK HOLLOW LANE
Practice Address - Street 2:
Practice Address - City:COMBINE
Practice Address - State:TX
Practice Address - Zip Code:75159
Practice Address - Country:US
Practice Address - Phone:214-534-5631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX677921363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX012834OtherPRESCRIPTION ID
TXJON104372854OtherNCC ID