Provider Demographics
NPI:1437161007
Name:GARCIA, JANE DAVIS (ANP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:DAVIS
Last Name:GARCIA
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:LORA
Other - Middle Name:JANE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:914 MUIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-3447
Mailing Address - Country:US
Mailing Address - Phone:704-663-6926
Mailing Address - Fax:
Practice Address - Street 1:4208 SIX FORKS RD
Practice Address - Street 2:BLDG 1 SUITE 305A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5735
Practice Address - Country:US
Practice Address - Phone:800-632-6074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC41046163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse