Individual provider · Type 1 NPI

Ethan Davis Mallory, FNP-C

Family Nurse Practitioner · Joplin, MO

NPI number 1922976422 Active

About NPI 1922976422

Ethan Davis Mallory, FNP-C's National Provider Identifier is 1922976422, issued on Oct 27, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Joplin, MO. The record was last updated on Oct 27, 2025.