Provider Demographics
NPI:1366749707
Name:DAVIS, DAREL LOUIS (APN, FNP-C)
Entity type:Individual
Prefix:MR
First Name:DAREL
Middle Name:LOUIS
Last Name:DAVIS
Suffix:
Gender:M
Credentials:APN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8459 E ASKERSUND CV
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-6836
Mailing Address - Country:US
Mailing Address - Phone:901-237-6388
Mailing Address - Fax:
Practice Address - Street 1:8040 WOLF RIVER BLVD STE 103
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1773
Practice Address - Country:US
Practice Address - Phone:901-726-0200
Practice Address - Fax:901-278-3050
Is Sole Proprietor?:No
Enumeration Date:2011-02-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15569363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily