Provider Demographics
NPI:1982023859
Name:DAVIS, KAREN MICHELLE (DO)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MICHELLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:MICHELLE
Other - Last Name:JESSUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:6353 CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4100
Mailing Address - Country:US
Mailing Address - Phone:757-455-8833
Mailing Address - Fax:
Practice Address - Street 1:100 KINGSLEY LN STE 200
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-4604
Practice Address - Country:US
Practice Address - Phone:757-451-0929
Practice Address - Fax:757-763-6977
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.012193207V00000X
390200000X
VA0102206897207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program