Individual
SHARON R DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FPMHNP
Contact information
Practice address
248 E CAPITOL ST, 840 TRUST MARK BLDG, JACKSON, MS 39201-2503
(800) 632-6074
(866) 341-7509
Mailing address
383 BRIARWOOD RD, # 103, MERIDIAN, MS 39305-9648
(601) 679-7763
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R529656
MS
364SG0600X
Gerontology Clinical Nurse Specialist
R529656
MS
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
R529656
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04959317
—
MS
Enumeration date
06/29/2006
Last updated
08/17/2007
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