Jama Bradford Davis, APN
Individual provider Active NPI Nurse Practitioner · Marion, AR
NPI 1194089763 · NPPES record last updated Dec 9, 2016
Key facts
- NPI
- 1194089763
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- A003724 (AR)
- Practice address
- 303 Bancario
Suite 1
Marion, AR 72364-2825 - Phone
- (870) 739-8670
- Fax
- (870) 739-8706
- NPI assigned
- Jun 28, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | A003724 | AR | Yes |
Addresses
Primary practice location
303 Bancario
Suite 1
Marion, AR 72364-2825
Mailing address
30 Burton Hills Blvd
Ste 175
Nashville, TN 37215-6403
Phone (615) 864-8703
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 193487758 | Medicaid | AR |
Other providers in Marion, AR
- Kimberly Dawne Crutchfield
- Anthony Cunningham
- Darenique Cunningham
- Freda Cunningham
- Matthew Daigle
- Dayspring Services of Arkansas LLC
- Suzanne Burns Degan
- Delta Eye Care LLC
- Dorothy Anna Mae Donelson
- Miracle Donnerson
All providers in Marion, AR · Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.