Provider Demographics
NPI:1801157953
Name:JONES, MELINDA ROSE (RDN, PA-C)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:ROSE
Last Name:JONES
Suffix:
Gender:F
Credentials:RDN, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:NM
Mailing Address - Zip Code:87942-0212
Mailing Address - Country:US
Mailing Address - Phone:575-201-3344
Mailing Address - Fax:
Practice Address - Street 1:333 1ST ST STE A
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-2661
Practice Address - Country:US
Practice Address - Phone:888-803-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1069103133V00000X
ORLD-D-10245254133V00000X
WADI61576632133V00000X
NMPA2017-0074363A00000X
CAPA64903363A00000X
NMNDP-2023-0109133V00000X
NY033034-01363A00000X
ORPA221723363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered