Provider Demographics
NPI:1811015605
Name:DAVIS, SUSAN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:ARNP
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 SW 172ND AVE
Mailing Address - Street 2:MEMORIAL HOSPITAL MIRAMAR-EMPLOYEE HEALTH
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5592
Mailing Address - Country:US
Mailing Address - Phone:954-538-4717
Mailing Address - Fax:954-538-4713
Practice Address - Street 1:1901 SW 172ND AVE
Practice Address - Street 2:MEMORIAL HOSPITAL MIRAMAR-EMPLOYEE HEALTH
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5592
Practice Address - Country:US
Practice Address - Phone:954-538-4717
Practice Address - Fax:954-538-4713
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL790612363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health