Healthcare Provider Details

I. General information

NPI: 1699762690
Provider Name (Legal Business Name): JANIE ELIZABETH DAVIS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 SUGAR MAPLE DR
AUBURN KY
42206-5352
US

IV. Provider business mailing address

128 SUGAR MAPLE DR
AUBURN KY
42206-5352
US

V. Phone/Fax

Practice location:
  • Phone: 270-344-5157
  • Fax:
Mailing address:
  • Phone: 270-344-5157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3902P
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3003902P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: