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General NPI Number Information
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NPI Number | 1790976330
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Entity Type | Individual
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Provider Name | JENNIFER STARR DAVIS PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 07/27/2024
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Provider Practice Location Address
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Address Line | 2220 SE OCEAN BLVD STE 301
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City | STUART
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State | FL
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Zip | 34996-3301
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Country | US
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Telephone | 772-220-3339
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Fax | 772-286-2635
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Provider Business Mailing Address
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Address Line | 2336 SE OCEAN BLVD STE 145
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City | STUART
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State | FL
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Zip | 34996-3310
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Country | US
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Telephone | 772-220-3339
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Fax | 772-286-2635
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4357
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9104207
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License Number State | FL
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