Provider Demographics
NPI:1003282310
Name:DAVIS, RACHELL RENEE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:RACHELL
Middle Name:RENEE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 N MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3809
Mailing Address - Country:US
Mailing Address - Phone:407-423-7149
Mailing Address - Fax:407-422-0470
Practice Address - Street 1:736 N MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3809
Practice Address - Country:US
Practice Address - Phone:407-423-7149
Practice Address - Fax:407-422-0470
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN83115363L00000X
FLAPRN11009288363LP0808X
OR201505905NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health