Annette Patricia Davenport, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2016030306 Issued in MO

Practice address

1551 Wall Street, Logistics Health Inc
Suite 100
Saint Charles, MO 63303

Phone

(636) 669-2444

NPI assigned

Aug 23, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Annette Patricia Davenport Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1487109146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5132 N ELSTON AVE",
            "address_2": "KAREFIRST MISSOURI PC",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302529",
            "telephone_number": "847-235-6130",
            "fax_number": "847-235-6135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 WALL STREET, LOGISTICS HEALTH INC",
            "address_2": "SUITE 100",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "63303",
            "telephone_number": "636-669-2444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2626 Solway Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631361541",
            "country_code": "US",
            "telephone_number": "314-306-8222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "ANNETTE",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016030306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNETTE",
            "last_name": "DAVENPORT",
            "middle_name": "PATRICIA",
            "prefix": "MRS.",
            "credential": "FNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Andrew M Daquila, P.T.
• Elaine Darden
• Laquita Darden
• Dare to Heal Therapy LLC
• Alfredo R. Davila, LMSW
• Diana Davis
• Jerrica Davis
• Linda S Davis, DC
• Grace Dean, PSY.D.

• Family Nurse Practitioner in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.