Provider Demographics
NPI:1407258114
Name:DAVIES, KRISTIN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:
Last Name:DAVIES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746649
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6649
Mailing Address - Country:US
Mailing Address - Phone:904-202-2092
Mailing Address - Fax:904-376-4075
Practice Address - Street 1:14540 OLD SAINT AUGUSTINE RD STE 2207
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-7419
Practice Address - Country:US
Practice Address - Phone:904-224-8090
Practice Address - Fax:904-391-5507
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9269480363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01397767OtherRAILROAD MEDICARE
FL013793300Medicaid
FLHZ537ZMedicare PIN