Active NPI
Jennifer Nicole Davis, APRN
- Nurse Practitioner
- Jacksonville, FL
National Provider Identifier
1487483640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 11034057
- Practice address
- 4668 Town Crossing Dr Ste 119
Jacksonville, FL 32246-7422 - Phone
- (904) 740-4004
- NPI assigned
- Jul 27, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 11034057 | FL | Primary |
Addresses
Primary practice location
4668 Town Crossing Dr Ste 119
Jacksonville, FL 32246-7422
Mailing address
4668 Town Crossing Dr Ste 119
Jacksonville, FL 32246-7422
Phone (904) 740-4004
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11034057 | FL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769644800000",
"number": "1487483640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4668 TOWN CROSSING DR STE 119",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322467422",
"telephone_number": "904-740-4004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4668 TOWN CROSSING DR STE 119",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322467422",
"telephone_number": "904-740-4004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JENNIFER",
"middle_name": "NICOLE",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-27",
"last_updated": "2026-01-29",
"certification_date": "2026-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "11034057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.