Individual
MRS. JACQUALYN S FANELLE
Active
Individual
MRS. JACQUALYN S FANELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR07270700
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
26NJ00207600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39668
AANA
—
01
—
P00795657
RAILROAD MEDICARE
NJ
Enumeration date
05/01/2007
Last updated
09/20/2013
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