Provider Demographics
NPI:1376597336
Name:DAVIS-WESTER, CHRISTY E (APRN)
Entity Type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:E
Last Name:DAVIS-WESTER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2367 HUMMINGBIRD DRIVE
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32448
Mailing Address - Country:US
Mailing Address - Phone:850-526-4555
Mailing Address - Fax:850-526-1066
Practice Address - Street 1:1376 BRICKYARD RD STE 2
Practice Address - Street 2:
Practice Address - City:CHIPLEY
Practice Address - State:FL
Practice Address - Zip Code:32428-6392
Practice Address - Country:US
Practice Address - Phone:850-638-0552
Practice Address - Fax:850-638-0504
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2749462363L00000X
FLAPRN2749462363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307351300Medicaid
FLU6840ZMedicare ID - Type UnspecifiedMEDICARE INDIVIDUAL