Individual provider Active NPI

Jenrenee Lorraine Fairlane, RN

  • Community Health Registered Nurse
  • Seattle, WA
National Provider Identifier
1306333539
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
RN60467707 Issued in WA
Practice address
2124 4TH Ave FL 3
Seattle, WA 98121-2308
Phone
(206) 477-7544
Fax
(206) 296-9960
NPI assigned
Apr 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN60467707 WA Primary

Addresses

Primary practice location

2124 4TH Ave FL 3
Seattle, WA 98121-2308

Mailing address

2124 4TH Ave FL 3
Seattle, WA 98121-2308
Phone (206) 477-7544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN60467707WAMDCommunity Health Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1306333539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 4TH AVE FL 3",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212308",
            "telephone_number": "206-477-7544",
            "fax_number": "206-296-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 4TH AVE FL 3",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212308",
            "telephone_number": "206-477-7544",
            "fax_number": "206-296-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRLANE",
        "first_name": "JENRENEE",
        "middle_name": "LORRAINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-13",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "WA",
            "license": "RN60467707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.