Provider Demographics
NPI:1275811994
Name:DAVIS, JOEL (ARNP)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:DAVIS
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19197 NATURES VIEW CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6221
Mailing Address - Country:US
Mailing Address - Phone:954-993-2079
Mailing Address - Fax:
Practice Address - Street 1:19197 NATURES VIEW CT
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-6221
Practice Address - Country:US
Practice Address - Phone:954-993-2079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNP9209344363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner