Provider Demographics
NPI:1053313536
Name:DAVIS, MARGARET JEAN (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:JEAN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 425
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-0425
Mailing Address - Country:US
Mailing Address - Phone:423-915-5233
Mailing Address - Fax:423-952-3109
Practice Address - Street 1:4276 LEGEND AVENUE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-3497
Practice Address - Country:US
Practice Address - Phone:910-867-0035
Practice Address - Fax:910-867-0545
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110512363LP0808X
MO2006023930363LP0808X
NC200842363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6113058Medicaid
NE31594OtherBLUE CROSS BLUE SHIELD NE
NE31594OtherBLUE CROSS BLUE SHIELD NE
NEP65589Medicare UPIN