Healthcare Provider Details

I. General information

NPI: 1437634540
Provider Name (Legal Business Name): MICHAELA SEWARD JONES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 DEVINE ST STE 3
NORTH HAVEN CT
06473-2222
US

IV. Provider business mailing address

6 DEVINE ST STE 3
NORTH HAVEN CT
06473-2222
US

V. Phone/Fax

Practice location:
  • Phone: 203-495-2410
  • Fax:
Mailing address:
  • Phone: 203-495-2410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number11469
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: