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NPI Code Detail

MEDICARE: MRS. CONNIE DAVIS ARNP,CWON,DAPWCA

MEDICARE:  MRS. CONNIE  DAVIS  ARNP,CWON,DAPWCA
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
1363LF0000XFamily Nurse PractitionerARNP2634772FL

General Provider Information

NPI Number : 1417078692
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CONNIE DAVIS ARNP,CWON,DAPWCA
Provider Business Mailing Address
First Line : 2009 S MOONLIT PT
Second Line :
City : HOMOSASSA
State : FL
Zip : 34448-2164
Country : US
Telephone Number : 352-628-3393
Fax Number : 352-628-3393
Provider Business Practice Location Address
First Line : 700 SE 5TH TER STE 2
Second Line :
City : CRYSTAL RIVER
State : FL
Zip : 34429-4865
Country : US
Telephone Number : 352-564-0444
Fax Number : 352-564-4222
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. CONNIE DAVIS ARNP,CWON,DAPWCA” Practice Location

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