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NPI Code Detail

MEDICARE: DR. MARY E DAVIS DNP, ARNP

MEDICARE: DR. MARY E DAVIS DNP, ARNP
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
1363LA2100XAcute Care Nurse PractitionerARNP9208450FL
2363LF0000XFamily Nurse Practitioner1080000TX
3363LP0808XPsychiatric/Mental Health Nurse PractitionerARNP9208450FL
4363LP0808XPsychiatric/Mental Health Nurse Practitioner1080000TX
5363LP0808XPsychiatric/Mental Health Nurse Practitioner0024191696VA
6363LF0000XFamily Nurse PractitionerARNP9208450FL

Other Identifiers

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

General Provider Information

NPI Number : 1770038093
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY E DAVIS DNP, ARNP
Provider Business Mailing Address
First Line : 2467B DIEHL DR
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-3870
Country : US
Telephone Number : 850-443-6621
Fax Number : 757-251-0879
Provider Business Practice Location Address
First Line : 4360 SHORE DR STE 101
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23455-2994
Country : US
Telephone Number : 757-251-0879
Fax Number : 757-251-0879
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2016
Last Update Date : 02/28/2025

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