Provider Demographics
NPI:1316507718
Name:DAVIS, KRISTA JOY RENAE (NP)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:JOY RENAE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:324 CORAL HILLS RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3808
Mailing Address - Country:US
Mailing Address - Phone:915-996-5685
Mailing Address - Fax:
Practice Address - Street 1:7812 GATEWAY BLVD E STE 120
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1811
Practice Address - Country:US
Practice Address - Phone:915-577-0100
Practice Address - Fax:915-633-1445
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2024-07-05
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Provider Licenses
StateLicense IDTaxonomies
AZ306316363LA2100X
UT13863457-4405363LA2100X
NM74977363LA2100X
TXAP141048363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care