Provider Demographics
NPI:1124428859
Name:SAWALL, JANE ANN (RN, CNS-BC)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:ANN
Last Name:SAWALL
Suffix:
Gender:F
Credentials:RN, CNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1047 BROOKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-5611
Mailing Address - Country:US
Mailing Address - Phone:541-301-5412
Mailing Address - Fax:
Practice Address - Street 1:1047 BROOKDALE AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-5611
Practice Address - Country:US
Practice Address - Phone:541-301-5412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200570015CNS364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health