Provider Demographics
NPI:1952659872
Name:DAVIS, NORMA JEAN (ARNP)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:JEAN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 N TEMPLE AVE
Mailing Address - Street 2:
Mailing Address - City:STARKE
Mailing Address - State:FL
Mailing Address - Zip Code:32091-1960
Mailing Address - Country:US
Mailing Address - Phone:904-964-7732
Mailing Address - Fax:904-964-3829
Practice Address - Street 1:1801 N TEMPLE AVE
Practice Address - Street 2:
Practice Address - City:STARKE
Practice Address - State:FL
Practice Address - Zip Code:32091-1960
Practice Address - Country:US
Practice Address - Phone:904-964-7732
Practice Address - Fax:904-964-3829
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3404822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily