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NPI Code Detail

MEDICARE: JK MAG-FNP LTD

MEDICARE: JK MAG-FNP LTD
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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1649526922
Entity Type Code : Organization
Provider Name (Legal Business Name) : JK MAG-FNP LTD
Provider Business Mailing Address
First Line : PO BOX 442
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81502-0442
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 735 BOOKCLIFF AVE # D
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81501-8107
Country : US
Telephone Number : 877-422-2740
Fax Number :
Authorized Official
Title or Position : MEMBER/PARTNER
Name : JORDAN MAGURAN
Credential :
Telephone Number : 877-422-2740
Provider Enumeration Date : 07/24/2012
Last Update Date : 07/24/2012

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Directions to “JK MAG-FNP LTD ” Practice Location

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