Provider Demographics
NPI:1033592985
Name:DAVIS, AUBREE JEAN (FNP-C)
Entity Type:Individual
Prefix:
First Name:AUBREE
Middle Name:JEAN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:AUBREE
Other - Middle Name:
Other - Last Name:VYLETA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:315 BIG OAK DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MS
Mailing Address - Zip Code:39073-9540
Mailing Address - Country:US
Mailing Address - Phone:601-259-1599
Mailing Address - Fax:
Practice Address - Street 1:3794 HIGHWAY 468 W
Practice Address - Street 2:
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-9008
Practice Address - Country:US
Practice Address - Phone:601-932-2880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR874779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily