Marianne M Davenport, APRN
Individual provider Active NPI Nurse Practitioner · Orange Park, FL
NPI 1699701441 · NPPES record last updated Apr 14, 2023
Key facts
- NPI
- 1699701441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APRN647182 (FL)
- Practice address
- 2140 Smith St
Orange Park, FL 32073-5554 - Phone
- (904) 269-2140
- Fax
- (904) 264-3018
- NPI assigned
- Jun 23, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN647182 | FL | MD | Nurse Practitioner |
| 647182 | FL | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Primary Care Inc | Nurse Practitioner | Past | Accepting new patients |
| Baptist Primary Care Inc | Past | Accepting new patients |
Interoperability endpoints
- mdavenport20974@baptisthealthsystemjacksonville.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 647182 | FL | |
| Pediatric Nurse Practitioner | 363LP0200X | APRN647182 | FL | |
| Nurse Practitioner | 363L00000X | APRN647182 | FL | Yes |
Addresses
Primary practice location
2140 Smith St
Orange Park, FL 32073-5554
Mailing address
PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-1032
Other providers in Orange Park, FL
- Kelly Daniels
- Melanie Daniles
- Nikki Darbani
- Ward Daron
- Andrew Bryson Dashiell
- David a Mosborg MD
- David S Hyler II MD PA
- Kenia Nahomi Davila Ortiz
- Ann Elise Davis
- Jennifer Davis
All providers in Orange Park, FL · Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2023. 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.