Provider Demographics
NPI:1164402418
Name:DAVIS, CHRISTINE ELIZABETH (ARNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ELIZABETH
Last Name: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 1:1324 SEVEN SPRINGS BLVD
Mailing Address - Street 2:#321
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5635
Mailing Address - Country:US
Mailing Address - Phone:727-364-3791
Mailing Address - Fax:727-376-3873
Practice Address - Street 1:1324 SEVEN SPRINGS BLVD
Practice Address - Street 2:#321
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-5635
Practice Address - Country:US
Practice Address - Phone:727-364-3791
Practice Address - Fax:727-376-3873
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3403642363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY068BOtherFL BCBS
FL306282100Medicaid
FL306282100Medicaid
FLY068BOtherFL BCBS
FLU2773SMedicare PIN
FLU2773TMedicare PIN