Provider Demographics
NPI:1760280978
Name:JONES, MELISSA LEE (CHW)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LEE
Last Name:JONES
Suffix:
Gender:
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 WINSTON DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-3647
Mailing Address - Country:US
Mailing Address - Phone:573-301-8076
Mailing Address - Fax:
Practice Address - Street 1:3721 W TRUMAN BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-0536
Practice Address - Country:US
Practice Address - Phone:573-634-2628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO10009309172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker