MEDICARE: MS. BELVERLY J JONES FNP

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	363LF0000X	Family Nurse Practitioner	4704128055	MI

General Provider Information

NPI Number	:	1306844998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BELVERLY J JONES FNP

Provider Business Mailing Address
First Line	:	1560 E MAPLE RD
Second Line	:	SUITE 400 - CREDENTIALING DEPT
City	:	TROY
State	:	MI
Zip	:	48083-1138
Country	:	US
Telephone Number	:	313-745-4525
Fax Number	:	313-577-3223

Provider Business Practice Location Address
First Line	:	3901 CHRYSLER DR
Second Line	:	STE 4A
City	:	DETROIT
State	:	MI
Zip	:	48201-2167
Country	:	US
Telephone Number	:	313-745-4525
Fax Number	:	313-577-3223

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	01/29/2017

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