Provider Demographics
NPI:1932756590
Name:DAVIS, DANA (APRN)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 SUNFOREST DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-6318
Mailing Address - Country:US
Mailing Address - Phone:833-766-1079
Mailing Address - Fax:813-355-5101
Practice Address - Street 1:5130 SUNFOREST DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-6318
Practice Address - Country:US
Practice Address - Phone:833-766-1079
Practice Address - Fax:813-355-5101
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11003761363L00000X, 363LG0600X, 363LP2300X, 363LA2200X
NC5018272363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care