Individual
JESSICA JARVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 UTAH ST STE 200, HIAWATHA, KS 66434-2314
(785) 742-2161
(785) 742-6558
Mailing address
300 UTAH ST, HIAWATHA, KS 66434-2326
(785) 742-2131
(785) 742-6588
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-38507
KS
207Q00000X
Family Medicine Physician
Primary
9408091
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016289105
PTAN
KS
05
—
30004413880001
—
KS
Enumeration date
05/13/2013
Last updated
03/11/2026
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