Healthcare Provider Details

I. General information

NPI: 1205954732
Provider Name (Legal Business Name): JOY M DAVIS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 N MAIN ST
DUBLIN PA
18917-2108
US

IV. Provider business mailing address

32 RIDGE VALLEY RD
OTTSVILLE PA
18942-9726
US

V. Phone/Fax

Practice location:
  • Phone: 215-249-9020
  • Fax: 215-249-3469
Mailing address:
  • Phone: 215-348-5046
  • Fax: 215-348-8799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberUP005055C
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: