Individual
JACK ADAM DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1200 PLEASANT ST, DES MOINES, IA 50309-1406
(515) 241-6372
Mailing address
4201 WESTOWN PKWY STE 236, WEST DES MOINES, IA 50266-6720
(515) 401-1950
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
121287
IA
Other
Enumeration date
09/27/2013
Last updated
06/26/2024
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