Provider Demographics
NPI:1043384118
Name:DAVIE, NANCY E (PSYD LMCH)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:E
Last Name:DAVIE
Suffix:
Gender:F
Credentials:PSYD LMCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MACCLENNY
Mailing Address - State:FL
Mailing Address - Zip Code:32063-2303
Mailing Address - Country:US
Mailing Address - Phone:904-259-1758
Mailing Address - Fax:904-259-9553
Practice Address - Street 1:117 S 5TH ST
Practice Address - Street 2:
Practice Address - City:MACCLENNY
Practice Address - State:FL
Practice Address - Zip Code:32063-2303
Practice Address - Country:US
Practice Address - Phone:904-259-1758
Practice Address - Fax:904-259-9553
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0003067101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ6736Medicare UPIN
169263Medicare UPIN
272031Medicare UPIN
FL2016499Medicare UPIN
FL239885Medicare UPIN
FL5378011Medicare UPIN
9426111Medicare UPIN
FLDAVNANCYMedicare UPIN