Jacqueline Davis, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2490192 Issued in MN

Practice address

2018 15TH St NW
Rochester, MN 55901-0716

Phone

(507) 281-1676

NPI assigned

Sep 26, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Thrifty Drug Stores Inc

  • Community/Retail Pharmacy
  • Wadena, MN
  • NPI 1710678545
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632614400000",
    "number": "1447921754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4878 170TH LN NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553041717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 15TH ST NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559010716",
            "telephone_number": "507-281-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JACQUELINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-26",
        "last_updated": "2021-09-26",
        "certification_date": "2021-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2490192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Wilson Davis III, PHARM D.
• Dudley H. Davis, M.D.
• Ethan J Davis
• Fred Paul Davis IV, DO
• Gloria Louise Davis, CRNA
• Jennifer Lynne Davis, LICSW
• Jessica Michelle Davis, M.D.
• John Manley Davis III, M.D.
• Katelynn Elizabeth Davis, M.D.
• Kristen Davis

• Registered Nurse in Rochester, MN
• Providers in Rochester, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.