Healthcare Provider Details

I. General information

NPI: 1659057040
Provider Name (Legal Business Name): JADA K DAVIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 N FLOWOOD DR STE A2
FLOWOOD MS
39232-9738
US

IV. Provider business mailing address

PO BOX 320206
FLOWOOD MS
39232-0206
US

V. Phone/Fax

Practice location:
  • Phone: 601-688-8027
  • Fax:
Mailing address:
  • Phone: 601-688-8027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number232095
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number906062
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: