MEDICARE: MRS. DAWN MARIE JARVEY REGISTERED NURSE

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
1	163WH0200X	Home Health Registered Nurse	4704334126	MI

General Provider Information

NPI Number	:	1578302352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAWN MARIE JARVEY REGISTERED NURSE

Provider Business Mailing Address
First Line	:	408 WISCONSIN AVE
Second Line	:
City	:	GLADSTONE
State	:	MI
Zip	:	49837-1831
Country	:	US
Telephone Number	:	906-399-2643
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 MINNEAPOLIS AVE
Second Line	:
City	:	GLADSTONE
State	:	MI
Zip	:	49837-2060
Country	:	US
Telephone Number	:	906-282-7607
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2024
Last Update Date	:	05/22/2024

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