Provider Demographics
NPI:1346768272
Name:DAVIS, JESSICA AMIEE (PCHW, RM, RYT)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:AMIEE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PCHW, RM, RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 E 40TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64129-1713
Mailing Address - Country:US
Mailing Address - Phone:816-665-7514
Mailing Address - Fax:
Practice Address - Street 1:6008 FOREST AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-3142
Practice Address - Country:US
Practice Address - Phone:816-866-7044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2021-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO374K00000X, 374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner