MEDICARE: MS. JANA DEL SANDERS APRN NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	89042	OK

General Provider Information

NPI Number	:	1952751307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANA DEL SANDERS APRN NP-C

Provider Business Mailing Address
First Line	:	614 NW 49TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-6604
Country	:	US
Telephone Number	:	405-626-7571
Fax Number	:

Provider Business Practice Location Address
First Line	:	614 NW 49TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-6604
Country	:	US
Telephone Number	:	405-626-7571
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2016
Last Update Date	:	07/11/2017

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