Provider Demographics
NPI:1184938540
Name:DAVIS, MARCY (RN, ARNP)
Entity type:Individual
Prefix:
First Name:MARCY
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4238 LEO LN
Mailing Address - Street 2:APT 231
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-7403
Mailing Address - Country:US
Mailing Address - Phone:561-313-3510
Mailing Address - Fax:561-844-0649
Practice Address - Street 1:365 STIRRUP KEY BLVD
Practice Address - Street 2:
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-2943
Practice Address - Country:US
Practice Address - Phone:561-313-3510
Practice Address - Fax:561-844-0649
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9167001363L00000X
FLRN9167001163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse