MEDICARE: MRS. AMY ELIZABETH DAVIS CPM

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	176B00000X	Midwife	99229	TX

General Provider Information

NPI Number	:	1891157772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY ELIZABETH DAVIS CPM

Provider Business Mailing Address
First Line	:	993 DOWITCHER DR
Second Line	:
City	:	SATELLITE BEACH
State	:	FL
Zip	:	32937-2872
Country	:	US
Telephone Number	:	214-546-4156
Fax Number	:

Provider Business Practice Location Address
First Line	:	993 DOWITCHER DR
Second Line	:
City	:	SATELLITE BEACH
State	:	FL
Zip	:	32937-2872
Country	:	US
Telephone Number	:	214-546-4156
Fax Number	:

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

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	03/22/2016

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