Provider Demographics
NPI:1942811161
Name:DAVIS, MICHAEL JAMES (FNP-BC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAMES
Last Name:DAVIS
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 UNION PARK RD # 8
Mailing Address - Street 2:
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-1711
Mailing Address - Country:US
Mailing Address - Phone:207-200-5907
Mailing Address - Fax:207-544-5157
Practice Address - Street 1:30 GOVERNORS WAY
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1680
Practice Address - Country:US
Practice Address - Phone:207-650-4762
Practice Address - Fax:207-544-5157
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-11
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP201139363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily