Provider Demographics
NPI:1215055579
Name:PRIVATEER, JANE LAGES (NP)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:LAGES
Last Name:PRIVATEER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:JANE
Other - Middle Name:LAGES
Other - Last Name:HEDEGARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4848 E CACTUS RD STE 940
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4164
Mailing Address - Country:US
Mailing Address - Phone:480-443-0050
Mailing Address - Fax:480-443-4018
Practice Address - Street 1:4848 E CACTUS RD STE 940
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4164
Practice Address - Country:US
Practice Address - Phone:480-443-0050
Practice Address - Fax:480-443-4018
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ074458363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner