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General NPI Number Information
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NPI Number | 1295614865
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Entity Type | Individual
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Provider Name | JACQUELINE DAVIS RN
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Gender | Female
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 28538 DUPONT BLVD
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City | MILLSBORO
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State | DE
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Zip | 19966-4791
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Country | US
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Telephone | 302-934-5052
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Fax |
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Provider Business Mailing Address
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Address Line | 31339 CHRIST CHURCH RD
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City | LAUREL
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State | DE
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Zip | 19956-3482
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Country | US
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Telephone | 302-604-8767
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | L1-0075604
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License Number State | DE
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