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General NPI Number Information
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NPI Number | 1225524812
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Entity Type | Individual
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Provider Name | JON R JARVIS APRN
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Gender | Male
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Dates
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Enumeration Date | 07/06/2018
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 117 W SOUTH ST
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City | MUNFORDVILLE
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State | KY
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Zip | 42765-9084
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Country | US
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Telephone | 270-524-7231
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Fax | 270-524-7415
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Provider Business Mailing Address
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Address Line | PO BOX 579
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City | MUNFORDVILLE
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State | KY
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Zip | 42765-0579
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Country | US
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Telephone | 270-524-7231
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Fax | 270-524-7415
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3012497
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License Number State | KY
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