Provider Demographics
NPI:1366874109
Name:DAVISSON, JULIE KAY (APRN, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:KAY
Last Name:DAVISSON
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:K
Other - Last Name:DAVISSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:3235 SW 34TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7502
Mailing Address - Country:US
Mailing Address - Phone:800-457-4573
Mailing Address - Fax:352-431-3173
Practice Address - Street 1:3235 SW 34TH ST STE 101
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7502
Practice Address - Country:US
Practice Address - Phone:352-431-3940
Practice Address - Fax:352-431-3173
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-03
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171075363LF0000X
MDAC003683363LP0808X
FLAPRN11026135363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty