Provider Demographics
NPI:1306862305
Name:DAVIS, BARBARA ANN (RN FIRST ASSIST)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN FIRST ASSIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 FAIRFAX CIR E
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-8612
Mailing Address - Country:US
Mailing Address - Phone:561-964-9048
Mailing Address - Fax:561-963-7584
Practice Address - Street 1:1312 FAIRFAX CIR E
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-8612
Practice Address - Country:US
Practice Address - Phone:561-964-9048
Practice Address - Fax:561-963-7584
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN869212171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor