Provider Demographics
NPI:1013342989
Name:SYLVESTER, JENNIFER SUZANNE (RN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SUZANNE
Last Name:SYLVESTER
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 1:1046 6TH AVE SW
Mailing Address - Street 2:DIABETES EDUCATION
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1916
Mailing Address - Country:US
Mailing Address - Phone:541-812-4839
Mailing Address - Fax:
Practice Address - Street 1:620 ELM ST SW
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1986
Practice Address - Country:US
Practice Address - Phone:541-812-4839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201391226RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse