Provider Demographics
NPI:1669634960
Name:ANDRUS, JANE ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:ANN
Last Name:ANDRUS
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 1:1122 FOREST PARK DR
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76087-2802
Mailing Address - Country:US
Mailing Address - Phone:817-598-0676
Mailing Address - Fax:
Practice Address - Street 1:1122 FOREST PARK DR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76087-2802
Practice Address - Country:US
Practice Address - Phone:817-598-0676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX569565163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse