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NPI Code Detail

MEDICARE: GWEN ELIZABETH DAVIS FNP-BC; PMHNP-BC

MEDICARE: GWEN ELIZABETH DAVIS FNP-BC; PMHNP-BC
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 PractitionerLG-0012517DE
2363L00000XNurse PractitionerLG-0012517DE
3363LP0808XPsychiatric/Mental Health Nurse PractitionerL8-001040457DE

General Provider Information

NPI Number : 1508207135
Entity Type Code : Individual
Provider Name (Legal Business Name) : GWEN ELIZABETH DAVIS FNP-BC; PMHNP-BC
Provider Business Mailing Address
First Line : 1515 SAVANNAH RD FL 2
Second Line :
City : LEWES
State : DE
Zip : 19958-1675
Country : US
Telephone Number : 302-645-3499
Fax Number : 302-644-4830
Provider Business Practice Location Address
First Line : 424 SAVANNAH RD
Second Line :
City : LEWES
State : DE
Zip : 19958-1462
Country : US
Telephone Number : 302-645-3026
Fax Number : 833-464-3793
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2013
Last Update Date : 05/29/2026

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