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General NPI Number Information
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NPI Number | 1629802368
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Entity Type | Individual
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Provider Name | JESSICA DWANNA DAVIS DNP, MBA, MSN, APRN,
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Gender | Female
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Dates
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Enumeration Date | 08/27/2024
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 31308 AMBERVIEW BND
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City | WESLEY CHAPEL
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State | FL
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Zip | 33545-4516
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Country | US
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Telephone | 318-562-8066
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Fax |
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Provider Business Mailing Address
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Address Line | 5111 PALMER RANCH PKWY
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City | SARASOTA
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State | FL
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Zip | 34238-4477
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11035091
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License Number State | FL
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