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General NPI Number Information
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NPI Number | 1275885303
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Entity Type | Individual
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Provider Name | DEBORAH ANN DAVIS ARNP
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Gender | Female
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Dates
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Enumeration Date | 10/13/2012
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Last Update Date | 07/29/2014
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Provider Practice Location Address
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Address Line | 10151 DEERWOOD PARK BLVD STE 200-250
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City | JACKSONVILLE
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State | FL
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Zip | 32256-0589
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Country | US
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Telephone | 904-309-9996
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Fax | 855-632-8329
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Provider Business Mailing Address
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Address Line | PO BOX 772
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City | PONTE VEDRA
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State | FL
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Zip | 32004-0772
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Country | US
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Telephone | 904-610-7203
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | ARNP2124972
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License Number State | FL
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