Healthcare Provider Details

I. General information

NPI: 1598251811
Provider Name (Legal Business Name): JAMIE N DAVIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 07/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 CARONDELET DR STE 112
KANSAS CITY MO
64114-4821
US

IV. Provider business mailing address

1010 CARONDELET DR STE 112
KANSAS CITY MO
64114-4821
US

V. Phone/Fax

Practice location:
  • Phone: 866-695-2867
  • Fax: 866-695-1107
Mailing address:
  • Phone: 866-695-2867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number20108023957
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: