MEDICARE: KAITLYN MAE JONES CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	65232	NM
2	363LW0102X	Women's Health Nurse Practitioner	65232	NM
3	367A00000X	Advanced Practice Midwife	812	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053914945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYN MAE JONES CNM

Provider Business Mailing Address
First Line	:	7708 4TH ST NW
Second Line	:
City	:	LOS RANCHOS
State	:	NM
Zip	:	87107-6510
Country	:	US
Telephone Number	:	505-924-2229
Fax Number	:

Provider Business Practice Location Address
First Line	:	4630 EUBANK BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2552
Country	:	US
Telephone Number	:	800-230-7526
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2020
Last Update Date	:	03/20/2025

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