Provider Demographics
NPI:1730977380
Name:ROSS SANDERS, JELESA (BSN, RN, ERRN)
Entity type:Individual
Prefix:
First Name:JELESA
Middle Name:
Last Name:ROSS SANDERS
Suffix:
Gender:
Credentials:BSN, RN, ERRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3185 BLUE BANKS LOOP RD NE
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-8965
Mailing Address - Country:US
Mailing Address - Phone:910-622-1947
Mailing Address - Fax:
Practice Address - Street 1:1650 GREENFIELD ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6456
Practice Address - Country:US
Practice Address - Phone:910-798-3500
Practice Address - Fax:910-798-7834
Is Sole Proprietor?:No
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC307636163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics