Provider Demographics
NPI:1043626427
Name:JACQUELINE F. SAUDER
Entity type:Organization
Organization Name:JACQUELINE F. SAUDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:FAY
Authorized Official - Last Name:SAUDER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:310-308-4638
Mailing Address - Street 1:5704 FREEPORT CT
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-5231
Mailing Address - Country:US
Mailing Address - Phone:310-308-4638
Mailing Address - Fax:
Practice Address - Street 1:5704 FREEPORT CT
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-5231
Practice Address - Country:US
Practice Address - Phone:310-308-4638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-07
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH198308251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care