Provider Demographics
NPI:1497343651
Name:DAVIS, SHERA ANN MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHERA
Middle Name:ANN MARIE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10299 SOUTHERN BLVD UNIT 212852
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33421-5116
Mailing Address - Country:US
Mailing Address - Phone:786-720-9350
Mailing Address - Fax:
Practice Address - Street 1:2480 PGA BLVD FL 33410
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3507
Practice Address - Country:US
Practice Address - Phone:561-622-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9430176163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice