Individual
MRS. JESSICA DIANE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NNP-BC
Contact information
Practice address
4301 GREATHOUSE SPRINGS ROAD, JOHNSON, AR 72741
(479) 684-3102
Mailing address
PO BOX 544, JOHNSON, AR 72741-0544
(479) 684-3102
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
2021005171
MO
363LN0000X
Neonatal Nurse Practitioner
Primary
230625
AR
Other
Enumeration date
09/14/2022
Last updated
10/14/2024
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