Provider Demographics
NPI:1538431309
Name:DAVIS, ELIZABETH S (FN P)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:S
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FN P
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1804 HIGHWAY 45 BYP STE 604
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-4403
Mailing Address - Country:US
Mailing Address - Phone:731-660-7971
Mailing Address - Fax:731-660-8739
Practice Address - Street 1:27 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3949
Practice Address - Country:US
Practice Address - Phone:731-424-1001
Practice Address - Fax:731-426-0344
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2018-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN16474363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily