Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 1372372 | FL |
NPI | 1013348937 |
---|---|
Provider Name | Mrs. Kimberly Mcfarling Davis |
First Address | Tampa, FL 33629-7713 |
Second Address | Brandon, FL 33511-6220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2013 |
Last Update Date | 24/01/2018 |