Provider Demographics
NPI:1649695560
Name:DAVIS, PASCALE (APRN, NP)
Entity type:Individual
Prefix:
First Name:PASCALE
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:APRN, NP
Other - Prefix:
Other - First Name:PASCALE
Other - Middle Name:
Other - Last Name:KIDANE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1900 N BAYSHORE DR APT 4314
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-3024
Mailing Address - Country:US
Mailing Address - Phone:888-947-3888
Mailing Address - Fax:
Practice Address - Street 1:1900 N BAYSHORE DR STE 1A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-3002
Practice Address - Country:US
Practice Address - Phone:888-947-3888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ239634363LP0808X
FL9178816363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty