Provider Demographics
NPI:1164563201
Name:SARNACKI, JEANINE (RN)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:
Last Name:SARNACKI
Suffix:
Gender:F
Credentials:RN
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 376
Mailing Address - Street 2:319 W. CALLE LA BOLITA
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-0376
Mailing Address - Country:US
Mailing Address - Phone:520-495-4252
Mailing Address - Fax:
Practice Address - Street 1:350 W SAHUARITA RD
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629-9000
Practice Address - Country:US
Practice Address - Phone:520-625-3502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN132990163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool