MEDICARE: JENNIFER DAWN DAVIS APRN

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	363LF0000X	Family Nurse Practitioner	13297	TN

General Provider Information

NPI Number	:	1447429386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER DAWN DAVIS APRN

Provider Business Mailing Address
First Line	:	451 HIGHWAY 13 S
Second Line	:
City	:	WAVERLY
State	:	TN
Zip	:	37185-2109
Country	:	US
Telephone Number	:	931-296-0211
Fax Number	:	931-296-0199

Provider Business Practice Location Address
First Line	:	186 HOSPITAL DR
Second Line	:
City	:	CAMDEN
State	:	TN
Zip	:	38320-1618
Country	:	US
Telephone Number	:	731-584-3151
Fax Number	:	731-584-3168

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

Provider Enumeration Date	:	02/25/2008
Last Update Date	:	11/30/2020

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