Provider Demographics
NPI:1447200837
Name:DAVIS, ELAINE D (APRN)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:D
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 1:4200 NW 90TH BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-3809
Mailing Address - Country:US
Mailing Address - Phone:352-378-2121
Mailing Address - Fax:877-552-6434
Practice Address - Street 1:4200 NW 90TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-3809
Practice Address - Country:US
Practice Address - Phone:352-378-2121
Practice Address - Fax:877-552-6434
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
APRN3168062101YM0800X
FLAPRN3168062363LP0808X, 363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily