Provider Demographics
NPI:1427391820
Name:DAVIS, KAREN JEANINE (FNP-C)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:JEANINE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:J
Other - Last Name:BATTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10165 COVERT AVE
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042
Mailing Address - Country:US
Mailing Address - Phone:562-243-6548
Mailing Address - Fax:
Practice Address - Street 1:5603 E 2ND ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-3905
Practice Address - Country:US
Practice Address - Phone:562-243-6548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA583713163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse