Basic Information
| Provider Information | |||||||||
| NPI: | 1932776093 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAUNDERS | ||||||||
| FirstName: | JENNA | ||||||||
| MiddleName: | GRACE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 576 FRED ROGERS DR | ||||||||
| Address2: | |||||||||
| City: | LATROBE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156503822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7245374441 | ||||||||
| FaxNumber: | 7245370146 | ||||||||
| Practice Location | |||||||||
| Address1: | 576 FRED ROGERS DR | ||||||||
| Address2: | |||||||||
| City: | LATROBE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156503822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7245374441 | ||||||||
| FaxNumber: | 7245370146 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2021 | ||||||||
| LastUpdateDate: | 06/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WI0600X | RN709687 | PA | Y | Nursing Service Providers | Registered Nurse | Infection Control |
No ID Information.