Provider Demographics
NPI:1649257924
Name:DAVIS, JANET KAY (APRN)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:KAY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:KAY
Other - Last Name:PRESLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:5041 N. 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504
Mailing Address - Country:US
Mailing Address - Phone:850-433-2155
Mailing Address - Fax:850-202-0600
Practice Address - Street 1:5151 N. 9TH AVENUE, 1ST FLOOR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504
Practice Address - Country:US
Practice Address - Phone:850-262-7830
Practice Address - Fax:850-449-6858
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1276572363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303786000Medicaid
FLY9013OtherBSFL
P15119Medicare UPIN
FLE4679ZMedicare ID - Type Unspecified