Healthcare Provider Details

I. General information

NPI: 1356181218
Provider Name (Legal Business Name): JENNIFER RUTH DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 W CENTRAL AVE STE D
TOLEDO OH
43606-3859
US

IV. Provider business mailing address

2150 W CENTRAL AVE STE D
TOLEDO OH
43606-3859
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-2192
  • Fax: 419-479-3297
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN.CNM.0019744
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WX0002X
TaxonomyHigh-Risk Obstetric Registered Nurse
License Number4704317826
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: