Provider Demographics
NPI:1457107757
Name:SANDERS, JEANNA (BSN RN AE-C)
Entity Type:Individual
Prefix:
First Name:JEANNA
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:BSN RN AE-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 WEST HANCOCK ST.
Mailing Address - Street 2:SCHOOL OF NURSING CBX 063
Mailing Address - City:MILLEDGEVILLE, GA 31061
Mailing Address - State:GA
Mailing Address - Zip Code:31061
Mailing Address - Country:US
Mailing Address - Phone:478-445-1076
Mailing Address - Fax:478-445-1121
Practice Address - Street 1:231 WEST HANCOCK ST.
Practice Address - Street 2:SCHOOL OF NURSING CBX 063
Practice Address - City:MILLEDGEVILLE, GA 31061
Practice Address - State:GA
Practice Address - Zip Code:31061
Practice Address - Country:US
Practice Address - Phone:478-445-1076
Practice Address - Fax:478-445-1121
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN165403163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse