Provider Demographics
NPI:1023811593
Name:DAVIS, DANTE TURRELL JR (FNP-C)
Entity type:Individual
Prefix:MR
First Name:DANTE
Middle Name:TURRELL
Last Name:DAVIS
Suffix:JR
Gender:M
Credentials:FNP-C
Other - Prefix:MR
Other - First Name:DANTE
Other - Middle Name:TURRELL
Other - Last Name:CHAMPION
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-1308
Practice Address - Street 1:125 INDIAN ROCK RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-2009
Practice Address - Country:US
Practice Address - Phone:603-890-6330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2380479163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency