Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 200400131 | NC |
Y | 111NI0900X | Internist | 200400131 | NC |
NPI | 1003802083 |
---|---|
Provider Name | Mrs. Novlet Jarrett Davis |
First Address | Holly Springs, NC 27540-7862 |
Second Address | Cary, NC 27511-4215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 08/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
143MM | BCBS OF NC (01) | NC |
188813 | MEDCOST (01) | NC |
5903674 | (05) | NC |
808427 | PARTNERS (01) | NC |
I43034 | (02) | NC |