Debra Venola Davis, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2022141296 Issued in AR

Practice address

3104 S Catalpa St Ste 9
Pine Bluff, AR 71603-4869

Phone

(870) 718-2822

NPI assigned

Jul 29, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Debra Venola Price Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1003645268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 S CATALPA ST STE 9",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034869",
            "telephone_number": "870-718-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 S CATALPA ST STE 9",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034869",
            "telephone_number": "870-718-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DEBRA",
        "middle_name": "VENOLA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "2022141296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "PRICE",
            "middle_name": "VENOLA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Ashley MD DMD Oral Surgery Group, a Professional Dental Corp
• David C Jacks MD PA
• David T.Nixon MD PA
• Davis Nursing Association
• Brionna Davis
• John Philip McKenzie Davis, DDS
• Lakita Davis
• Patricia A Davis, LCSW
• Dotiana Marnise Dawson
• DC Development PA

• Family Nurse Practitioner in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.