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General NPI Number Information
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NPI Number | 1609174002
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Entity Type | Individual
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Provider Name | EMMY JO DAVIS CNM
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Gender | Female
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Dates
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Enumeration Date | 03/09/2011
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Last Update Date | 08/18/2016
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Provider Practice Location Address
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Address Line | 417 S EAST ST
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City | CORYDON
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State | IA
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Zip | 50060-1860
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Country | US
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Telephone | 641-872-2063
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Fax | 641-872-2070
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Provider Business Mailing Address
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Address Line | 417 S EAST ST
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City | CORYDON
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State | IA
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Zip | 50060-1860
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Country | US
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Telephone | 641-872-2063
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Fax | 641-872-3116
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | B127278
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License Number State | IA
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