Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | APRN2835352 | FL |
N | 363LA2200X | Nurse Practitioner - Adult Health | ARNP2835352 | FL |
N | 363LC1500X | Nurse Practitioner - Community Health | APRN2835352 | FL |
Y | 363LG0600X | Nurse Practitioner - Gerontology | APRN2835352 | FL |
NPI | 1699187591 |
---|---|
Provider Name | Mary L Davis |
First Address | Sebring, FL 33870-4912 |
Second Address | Sebring, FL 33870-4912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2014 |
Last Update Date | 05/11/2021 |