Provider Demographics
NPI:1497416051
Name:DAVIS, ELISABETH J (APRN)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:J
Last Name:DAVIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ELISABETH
Other - Middle Name:B
Other - Last Name:JEFFCOTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 412503
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2503
Mailing Address - Country:US
Mailing Address - Phone:617-726-3884
Mailing Address - Fax:
Practice Address - Street 1:10 MEMBERS WAY
Practice Address - Street 2:5TH FLOOR
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-5933
Practice Address - Country:US
Practice Address - Phone:603-609-6800
Practice Address - Fax:603-609-6820
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH075886-23363LF0000X
NH075886-21163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH1000XNursing Service ProvidersRegistered NurseHospice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3136692Medicaid