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NPI Code Detail

MEDICARE: KIMBERLY RENEE DAVIS APRN

MEDICARE: KIMBERLY RENEE 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
1363LA2200XAdult Health Nurse PractitionerARNP 1768182FL

Other Identifiers

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

General Provider Information

NPI Number : 1598072688
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY RENEE DAVIS APRN
Provider Business Mailing Address
First Line : 1443 SAN MARCO BLVD STE 101
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8535
Country : US
Telephone Number : 904-253-6910
Fax Number : 904-253-6964
Provider Business Practice Location Address
First Line : 1443 SAN MARCO BLVD STE 101
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8535
Country : US
Telephone Number : 904-253-6910
Fax Number : 904-253-6964
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2010
Last Update Date : 08/20/2025

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Directions to “ KIMBERLY RENEE DAVIS APRN” Practice Location

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