Provider Demographics
NPI:1114023355
Name:DRAKE-DAVIS, DEBBIE JO (ARNP)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:JO
Last Name:DRAKE-DAVIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215-21ST AVENUE SOUTH, MCE
Mailing Address - Street 2:SUITE #5209
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-8802
Mailing Address - Country:US
Mailing Address - Phone:615-322-2318
Mailing Address - Fax:615-936-7372
Practice Address - Street 1:3601 TVC
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0001
Practice Address - Country:US
Practice Address - Phone:615-322-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN10461363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3649213Medicaid
TNQ34505Medicare UPIN
TN3649213Medicaid
TN3649213Medicare ID - Type Unspecified