Provider Demographics
NPI:1891587358
Name:DAVIS, ALEXANDER JAMESON (MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:JAMESON
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 NAPLES CT APT 510
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-3865
Mailing Address - Country:US
Mailing Address - Phone:808-724-0123
Mailing Address - Fax:
Practice Address - Street 1:600 NAPLES CT APT 510
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-3865
Practice Address - Country:US
Practice Address - Phone:808-724-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2024100396363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health