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General NPI Number Information
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NPI Number | 1538903760
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Entity Type | Individual
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Provider Name | JANA M. GODFREY RN
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Gender | Female
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Dates
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Enumeration Date | 06/22/2024
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 100 MERCY WAY STE 530
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City | JOPLIN
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State | MO
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Zip | 64804-4524
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Country | US
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Telephone | 417-556-3828
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Fax |
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Provider Business Mailing Address
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Address Line | 325 E 20TH ST
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City | PITTSBURG
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State | KS
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Zip | 66762-3129
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Country | US
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Telephone | 620-200-7466
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Fax |
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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 | 53-83535-071
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License Number State | KS
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