Provider Demographics
NPI:1639145899
Name:JAMESON, NANCY ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:JAMESON
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 1:4299 WESTCHESTER CIR
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55123-3048
Mailing Address - Country:US
Mailing Address - Phone:651-405-0040
Mailing Address - Fax:
Practice Address - Street 1:4299 WESTCHESTER CIR
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-3048
Practice Address - Country:US
Practice Address - Phone:651-405-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 086848-8367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered