Provider Demographics
NPI:1598656225
Name:SANDERS, JENNIFER CARYN
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CARYN
Last Name:SANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 PLEASANT AVE APT C20
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26537-1634
Mailing Address - Country:US
Mailing Address - Phone:681-209-1519
Mailing Address - Fax:
Practice Address - Street 1:203 PLEASANT AVE APT C20
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:WV
Practice Address - Zip Code:26537-1634
Practice Address - Country:US
Practice Address - Phone:681-209-1519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant