Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2008-01817 | NC |
N | 111NI0900X | Internist | 2008-01817 | NC |
Y | 207RH0002X | Hospice and Palliative Medicine | 200801817 | NC |
NPI | 1275712986 |
---|---|
Provider Name | Dr. Jennifer Lynn Davis |
First Address | Winston Salem, NC 27157-0001 |
Second Address | Lexington, NC 27292-6989 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2007 |
Last Update Date | 19/11/2018 |