MEDICARE: MS. CHARLOTTE LUCY WYNNE JONES AG-ACNP

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	163WC0200X	Critical Care Medicine Registered Nurse	R191678	MD
2	363LA2100X	Acute Care Nurse Practitioner	R191678	MD
3	363LA2100X	Acute Care Nurse Practitioner	NP95011751	CA

General Provider Information

NPI Number	:	1699163840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHARLOTTE LUCY WYNNE JONES AG-ACNP

Provider Business Mailing Address
First Line	:	2220 N CALVERT ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218-5813
Country	:	US
Telephone Number	:	202-906-9833
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 LOWER RAGSDALE DR STE 160
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-5840
Country	:	US
Telephone Number	:	202-906-9833
Fax Number	:

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

Provider Enumeration Date	:	12/22/2014
Last Update Date	:	03/07/2022

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