Provider Demographics
NPI:1780791335
Name:DAVIS, PAULA LYNN (MSN, APRN-BC)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:LYNN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MSN, APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 SW 146TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-4604
Mailing Address - Country:US
Mailing Address - Phone:352-339-0470
Mailing Address - Fax:
Practice Address - Street 1:103 SE 3RD ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:FL
Practice Address - Zip Code:32693-3247
Practice Address - Country:US
Practice Address - Phone:352-577-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN1647892363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP 1647892OtherARNP LICENSE