Healthcare Provider Details

I. General information

NPI: 1780791335
Provider Name (Legal Business Name): PAULA LYNN DAVIS MSN, APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/06/2024
Certification Date: 07/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 SE 3RD ST
TRENTON FL
32693-3247
US

IV. Provider business mailing address

1924 SW 146TH ST
NEWBERRY FL
32669-4604
US

V. Phone/Fax

Practice location:
  • Phone: 352-577-5252
  • Fax:
Mailing address:
  • Phone: 352-339-0470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN1647892
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: