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General NPI Number Information
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NPI Number | 1881914778
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Entity Type | Individual
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Provider Name | AMY JARVIS RN
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Gender | Female
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Dates
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Enumeration Date | 06/02/2010
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Last Update Date | 06/02/2010
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Provider Practice Location Address
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Address Line | 470 NE A ST
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City | MADRAS
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State | OR
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Zip | 97741-1844
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Country | US
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Telephone | 541-460-4030
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Fax | 541-475-0602
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Provider Business Mailing Address
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Address Line | 1505 NW BIRCH LN
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City | MADRAS
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State | OR
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Zip | 97741-9044
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Country | US
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Telephone |
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 086003275RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 163WH1000X
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Taxonomy Name | Hospice Registered Nurse
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License Number | 086003275RN
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License Number State | OR
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