Provider Demographics
NPI:1013944040
Name:DAVIDSON, JANICE (PHD FNP-BC FAANP)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:PHD FNP-BC FAANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 7TH ST S
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39701-6506
Mailing Address - Country:US
Mailing Address - Phone:662-328-6293
Mailing Address - Fax:
Practice Address - Street 1:514 7TH ST S
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39701-6506
Practice Address - Country:US
Practice Address - Phone:662-328-6293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR868061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily