Healthcare Provider Details

I. General information

NPI: 1225460652
Provider Name (Legal Business Name): PAULA M DAVIS-HUFFMAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2013
Last Update Date: 08/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10501 FGCU BLVD S
FORT MYERS FL
33965-6565
US

IV. Provider business mailing address

2240 MALIBU LAKE CIR APT 221
NAPLES FL
34119-8790
US

V. Phone/Fax

Practice location:
  • Phone: 239-590-7514
  • Fax:
Mailing address:
  • Phone: 813-508-1965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP2927912
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP2927912
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: