Provider Demographics
NPI:1821601543
Name:RAFTER, JANE COLLINS (BSN, RN)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:COLLINS
Last Name:RAFTER
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:KS
Mailing Address - Zip Code:66030-0056
Mailing Address - Country:US
Mailing Address - Phone:913-709-7731
Mailing Address - Fax:
Practice Address - Street 1:9408 WENONGA RD
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66206-2029
Practice Address - Country:US
Practice Address - Phone:913-709-7731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-87587-052163WI0500X
KS13-101490-041163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSA-070-004OtherHOME HEALTH AGENCY LICENSE