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NPI Code Detail

MEDICARE: STACY KATHRYN AMER-DAVIS N.P.

MEDICARE: STACY KATHRYN AMER-DAVIS N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PE0005XUndersea and Hyperbaric Medicine (Emergency Medicine) PhysicianNP20267CA
2363L00000XNurse PractitionerNP20267CA
3363L00000XNurse Practitioner4981901ID

General Provider Information

NPI Number : 1750661641
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY KATHRYN AMER-DAVIS N.P.
Provider Business Mailing Address
First Line : FILE NO 54826
Second Line :
City : LOS ANGELES
State : CA
Zip : 90074-4826
Country : US
Telephone Number : 562-468-0227
Fax Number :
Provider Business Practice Location Address
First Line : 2400 E 4TH ST
Second Line :
City : NATIONAL CITY
State : CA
Zip : 91950-2026
Country : US
Telephone Number : 619-470-4321
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2011
Last Update Date : 06/08/2026

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