Provider Demographics
NPI:1922162619
Name:DAVIS, JAMIE T (NP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:T
Last Name:DAVIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:1670 W MAIN ST
Mailing Address - Street 2:STE 140
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-1345
Mailing Address - Country:US
Mailing Address - Phone:615-453-9492
Mailing Address - Fax:615-453-9498
Practice Address - Street 1:1218 TROTWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-6406
Practice Address - Country:US
Practice Address - Phone:931-540-4140
Practice Address - Fax:931-540-4143
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2016-05-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN5456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily