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General NPI Number Information
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NPI Number | 1083561534
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Entity Type | Individual
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Provider Name | JHENNELL DAVIS MSN, APRN, AGNP-C
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Gender |
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 125 RICKEY BLVD UNIT 1471
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City | BEAR
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State | DE
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Zip | 19701-8662
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Country | US
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Telephone | 302-440-4353
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Fax |
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Provider Business Mailing Address
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Address Line | 125 RICKEY BLVD UNIT 1471
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City | BEAR
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State | DE
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Zip | 19701-8662
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | L1-0051892
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License Number State | DE
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