MEDICARE: MICHELLE A JONES MSN, FNP-C

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	363L00000X	Nurse Practitioner	71003545A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000905702	OTHER	IN	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366621484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE A JONES MSN, FNP-C

Provider Business Mailing Address
First Line	:	6326 CONSTITUTION DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-1518
Country	:	US
Telephone Number	:	260-515-3275
Fax Number	:	888-803-6843

Provider Business Practice Location Address
First Line	:	6326 CONSTITUTION DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-1518
Country	:	US
Telephone Number	:	260-515-3275
Fax Number	:	888-803-6843

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

Provider Enumeration Date	:	10/25/2007
Last Update Date	:	02/22/2023

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