Provider Demographics
NPI:1912660226
Name:DAVIS, NATALIE ANN (AGACNP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9271 SW 221ST WAY
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1463
Mailing Address - Country:US
Mailing Address - Phone:786-261-9312
Mailing Address - Fax:
Practice Address - Street 1:9271 SW 221ST WAY
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1463
Practice Address - Country:US
Practice Address - Phone:786-261-9312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11015976363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care