Provider Demographics
NPI:1144724196
Name:JEANES, RN, ANNETTE CECILIA (RN)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:CECILIA
Last Name:JEANES, RN
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 1:402 E CENTENNIAL RD
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-2078
Mailing Address - Country:US
Mailing Address - Phone:402-898-4858
Mailing Address - Fax:402-898-0415
Practice Address - Street 1:402 E CENTENNIAL RD
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-2078
Practice Address - Country:US
Practice Address - Phone:402-898-4858
Practice Address - Fax:402-898-0415
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE53067163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool