Pamela G Davis, NP
Individual provider Active NPI Family Nurse Practitioner · Jacksboro, TN
NPI 1780907238 · NPPES record last updated Feb 15, 2012
Key facts
- NPI
- 1780907238
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 14820 (TN)
- Practice address
- 281 Paradise LN
Jacksboro, TN 37757-3931 - Phone
- (865) 679-3306
- NPI assigned
- Mar 11, 2010
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14820 | TN | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 14820 | TN | Yes |
Addresses
Primary practice location
281 Paradise LN
Jacksboro, TN 37757-3931
Mailing address
281 Paradise LN
Jacksboro, TN 37757-3931
Phone (865) 679-3306
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6458P | Other | KY | KY LIC NUMBER |
Other providers in Jacksboro, TN
- Compassionate Home Health Care LLC
- Compassionate Home Health Care, LLC
- Charley Crockett
- Felicia Adele Crockett
- Crossroads Treatment Centers of Tennessee, PC
- Tonya L. Davis
- Subanithya Dhamotharan
- Riley K. Dunn
- Patricia Ann Eberharter
- Mercedes Sharon Edwards-Lay
All providers in Jacksboro, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2012. 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.