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NPI Code Detail

MEDICARE: JORDAN DAVIS NP

MEDICARE:   JORDAN  DAVIS  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner71014365AIN
2363LF0000XFamily Nurse Practitioner4010954KY

General Provider Information

NPI Number : 1295519791
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN DAVIS NP
Provider Business Mailing Address
First Line : PO BOX 309
Second Line :
City : WARSAW
State : KY
Zip : 41095-0309
Country : US
Telephone Number : 859-904-0033
Fax Number :
Provider Business Practice Location Address
First Line : 204 FRANKLIN ST
Second Line :
City : WARSAW
State : KY
Zip : 41095
Country : US
Telephone Number : 859-904-0033
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2023
Last Update Date : 01/21/2026

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