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General NPI Number Information
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NPI Number | 1538874102
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Entity Type | Individual
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Provider Name | JARED A DAVIS APNP
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Gender | Male
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Dates
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Enumeration Date | 01/18/2023
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 9260 MARKETPLACE DR STE 102
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City | MIAMISBURG
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State | OH
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Zip | 45342-4478
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Country | US
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Telephone | 888-938-3838
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Fax | 888-919-1083
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Provider Business Mailing Address
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Address Line | 10001 W INNOVATION DR STE 200
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City | MILWAUKEE
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State | WI
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Zip | 53226-4851
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Country | US
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Telephone | 888-938-3838
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Fax | 888-919-1083
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0032930
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License Number State | OH
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