Provider Demographics
NPI:1477578490
Name:SARGENT, JEWELL A (CRNA)
Entity Type:Individual
Prefix:
First Name:JEWELL
Middle Name:A
Last Name:SARGENT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 BEAVER HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-2617
Mailing Address - Country:US
Mailing Address - Phone:814-242-2897
Mailing Address - Fax:
Practice Address - Street 1:2129 BEAVER HILL RD
Practice Address - Street 2:
Practice Address - City:CHESTER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:19425-2617
Practice Address - Country:US
Practice Address - Phone:814-242-2897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA214043367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA016685N7NMedicare PIN