Provider Demographics
NPI:1205842226
Name:DAVIS-MORGAN, JAN (ARNP)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:
Last Name:DAVIS-MORGAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 10TH PL NE
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-4748
Mailing Address - Country:US
Mailing Address - Phone:509-884-5680
Mailing Address - Fax:
Practice Address - Street 1:701 N MILLER ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2086
Practice Address - Country:US
Practice Address - Phone:509-662-7195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00044044363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAQ18667Medicare UPIN
WA8859390Medicare ID - Type UnspecifiedMEDICARE