Healthcare Provider Details

I. General information

NPI: 1831763622
Provider Name (Legal Business Name): JORDAN LYNN BLAUFUSS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

774 ROAD M, OLPE, KS, 66865
OLPE KS
66865
US

IV. Provider business mailing address

420 W 15TH AVE
EMPORIA KS
66801-5367
US

V. Phone/Fax

Practice location:
  • Phone: 620-344-2126
  • Fax:
Mailing address:
  • Phone: 620-342-4864
  • Fax: 620-343-3545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number53-80200-072
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number80200
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: