Provider Demographics
NPI:1447995030
Name:JONES, KASEY (CRNP)
Entity type:Individual
Prefix:MRS
First Name:KASEY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 PROGRESS WAY
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6464
Mailing Address - Country:US
Mailing Address - Phone:410-795-0257
Mailing Address - Fax:
Practice Address - Street 1:1380 PROGRESS WAY STE 102
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6498
Practice Address - Country:US
Practice Address - Phone:410-795-0257
Practice Address - Fax:410-549-7354
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR205383363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily