Provider Demographics
NPI:1083637789
Name:SEARS, JANE MARIE (RN, MA, CNS)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:MARIE
Last Name:SEARS
Suffix:
Gender:F
Credentials:RN, MA, CNS
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:MAIRE
Other - Last Name:CHURCHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MA, CNS
Mailing Address - Street 1:1095 HIGHWAY 15 S
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-5000
Mailing Address - Country:US
Mailing Address - Phone:320-234-5000
Mailing Address - Fax:
Practice Address - Street 1:1095 HIGHWAY 15 S
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-5000
Practice Address - Country:US
Practice Address - Phone:320-234-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR078918-5364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNR93874Medicare UPIN