Healthcare Provider Details

I. General information

NPI: 1639589146
Provider Name (Legal Business Name): KEANDRA JONES APRN, CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2014
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9131 PISCATAWAY RD STE 700
CLINTON MD
20735-2508
US

IV. Provider business mailing address

12211 PLUM ORCHARD DR STE 220
SILVER SPRING MD
20904-7919
US

V. Phone/Fax

Practice location:
  • Phone: 310-599-0900
  • Fax: 301-599-7828
Mailing address:
  • Phone: 301-754-3060
  • Fax: 301-681-0789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR197298
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR197298
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: