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NPI Code Detail

MEDICARE: KAREN JEANINE DAVIS FNP-C

MEDICARE: KAREN JEANINE DAVIS FNP-C
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
1163W00000XRegistered Nurse583713CA
2363L00000XNurse Practitioner23618CA

General Provider Information

NPI Number : 1427391820
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN JEANINE DAVIS FNP-C
Provider Business Mailing Address
First Line : 269 TIVOLI DR
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-3645
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5603 E 2ND ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-3905
Country : US
Telephone Number : 562-243-6548
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2013
Last Update Date : 06/10/2024

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