Provider Demographics
NPI:1649027830
Name:DAVIS, KIMBERLY A (DOULA)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8227 HAMDEN CIR E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-6405
Mailing Address - Country:US
Mailing Address - Phone:904-303-5596
Mailing Address - Fax:
Practice Address - Street 1:8227 HAMDEN CIR E
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-6405
Practice Address - Country:US
Practice Address - Phone:904-303-5596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-04
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty