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1184731770

NPI Code Detail

MEDICARE: MS. JULIA CHRISTINE DAVIS PA.

MEDICARE: MS. JULIA CHRISTINE DAVIS PA.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant		NM
2	363AM0700X	Medical Physician Assistant	PA2006 0028	NM
3	363AM0700X	Medical Physician Assistant	PA2006-0028	NM
4	363AM0700X	Medical Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184731770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIA CHRISTINE DAVIS PA.

Provider Business Mailing Address
First Line	:	PO BOX 683
Second Line	:
City	:	JEMEZ PUEBLO
State	:	NM
Zip	:	87024-0683
Country	:	US
Telephone Number	:	575-834-7166
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 PASEO DE PERALTA
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87501-1922
Country	:	US
Telephone Number	:	505-989-8707
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	06/16/2018

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Directions to “ MS. JULIA CHRISTINE DAVIS PA.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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