# JAQUELINE MARGARET DAVIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1518989078
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | RN143842 | GA | Yes |

## Other

- **Enumeration date:** 07/24/2006
- **Last updated:** 06/14/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01067491 | AMERIGROUP | GA |
| 01 | — | 404178 | WELLCARE | GA |
| 01 | — | 50BBLLG | OLD MEDICARE PTAN | GA |
| 05 | — | 593466638A | — | GA |
| 01 | — | P00394154 | RR MEDICARE | GA |