Provider Demographics
NPI:1417197054
Name:NIEMANN, JAYNE ANN (BSN RN CNN)
Entity Type:Individual
Prefix:
First Name:JAYNE
Middle Name:ANN
Last Name:NIEMANN
Suffix:
Gender:F
Credentials:BSN RN CNN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 N EMPORIA ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-2944
Mailing Address - Country:US
Mailing Address - Phone:316-440-3900
Mailing Address - Fax:316-440-3905
Practice Address - Street 1:1035 N EMPORIA ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-2944
Practice Address - Country:US
Practice Address - Phone:316-440-3900
Practice Address - Fax:316-440-3905
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-052310-112163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse