Provider Demographics
NPI:1811933831
Name:PAGEL, JANE SUE (RN)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:SUE
Last Name:PAGEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:JANE
Other - Middle Name:SUE
Other - Last Name:SORG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:118 RAILROAD ST
Mailing Address - Street 2:PO BOX 122
Mailing Address - City:DANE
Mailing Address - State:WI
Mailing Address - Zip Code:53529
Mailing Address - Country:US
Mailing Address - Phone:608-849-3897
Mailing Address - Fax:
Practice Address - Street 1:519 HANERVILLE RD
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:WI
Practice Address - Zip Code:53589
Practice Address - Country:US
Practice Address - Phone:608-873-2821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
38207800Medicare UPIN