Provider Demographics
NPI:1871800318
Name:DAVIS, BRIAN MICHAEL (FNP)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:MICHAEL
Last Name:DAVIS
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:260 KING ST
Mailing Address - Street 2:APT 965
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-6400
Mailing Address - Country:US
Mailing Address - Phone:415-271-9270
Mailing Address - Fax:415-358-4743
Practice Address - Street 1:2727 MARIPOSA ST STE 100
Practice Address - Street 2:TRAUMA RECOVERY/RAPE TREATMENT CENTER
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1400
Practice Address - Country:US
Practice Address - Phone:415-437-3036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA19998363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily