Healthcare Provider Details

I. General information

NPI: 1205605805
Provider Name (Legal Business Name): JENNIFER ASHLEY DAVIS MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 N VERRADO WAY STE 108-B
BUCKEYE AZ
85396-1868
US

IV. Provider business mailing address

1545 N VERRADO WAY STE 108-B
BUCKEYE AZ
85396-1868
US

V. Phone/Fax

Practice location:
  • Phone: 480-499-1539
  • Fax:
Mailing address:
  • Phone: 480-499-1539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number301425
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: