Provider Demographics
NPI:1164697744
Name:XAVIER, JANE G (RN)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:G
Last Name:XAVIER
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 1:8045 E PORTOBELLO AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-1690
Mailing Address - Country:US
Mailing Address - Phone:480-507-1404
Mailing Address - Fax:480-507-1666
Practice Address - Street 1:8045 E PORTOBELLO AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-1690
Practice Address - Country:US
Practice Address - Phone:480-507-1404
Practice Address - Fax:480-507-1666
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN086548163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool