Provider Demographics
NPI:1649526922
Name:JK MAG-FNP LTD
Entity type:Organization
Organization Name:JK MAG-FNP LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGURAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-422-2740
Mailing Address - Street 1:PO BOX 442
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502-0442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:735 BOOKCLIFF AVE # D
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8107
Practice Address - Country:US
Practice Address - Phone:877-422-2740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care