Donna Davis

Individual provider Active NPI Licensed Practical Nurse · Madison, FL

NPI 1255878633 · NPPES record last updated Jan 24, 2017

Key facts

NPI
1255878633
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN1283461 (FL)
Practice address
218 SW Third Ave
Madison, FL 32340-1266
Phone
(850) 973-5000
Fax
(850) 973-5007
NPI assigned
Jan 24, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN1283461FLMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health Past Accepting new patients
Florida Department of Health Past
since Oct 18, 2006
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN1283461 FL Yes

Addresses

Primary practice location

218 SW Third Ave
Madison, FL 32340-1266

Mailing address

178 SW Allandale TRL
Madison, FL 32340-4413
Phone (850) 967-3500

Other providers in Madison, FL

All providers in Madison, FL · Licensed Practical Nurse in Florida

Sources for this page

Verify at the official NPI Registry.