MEDICARE: MS. JANICE LYNN BADENHOP DAVIS CNP

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	363LF0000X	Family Nurse Practitioner	NP-07914	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1124127683	OTHER	OH	THE JAMES INSTITUTE

General Provider Information

NPI Number	:	1578562237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANICE LYNN BADENHOP DAVIS CNP

Provider Business Mailing Address
First Line	:	811 E EVA CIR
Second Line	:
City	:	SPRINGFIELD
State	:	OH
Zip	:	45504-3776
Country	:	US
Telephone Number	:	937-323-2443
Fax Number	:

Provider Business Practice Location Address
First Line	:	2050 KENNY RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-3502
Country	:	US
Telephone Number	:	937-323-2443
Fax Number	:

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	06/02/2009

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