Provider Demographics
NPI:1851368047
Name:SUTTON, JANE L (NP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:L
Last Name:SUTTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5324 MCFARLAND DR. STE 150
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707
Mailing Address - Country:US
Mailing Address - Phone:919-354-7077
Mailing Address - Fax:919-354-7075
Practice Address - Street 1:5324 MCFARLAND DR. STE 150
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707
Practice Address - Country:US
Practice Address - Phone:919-354-7077
Practice Address - Fax:919-354-7075
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0428462303363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30011125Medicaid
NH30011125Medicaid
S62479Medicare UPIN