Individual
JENNIFER LYNN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
13611 SCHANG RD, EAST AURORA, NY 14052-9595
(845) 996-8176
Mailing address
612 CORPORATE WAY STE 2M, VALLEY COTTAGE, NY 10989-2027
(845) 996-8176
(718) 362-8185
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F310104-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F310104-01
LICENSE NUMBER OFFICE OF PROFESSIONALS
NY
Enumeration date
12/07/2020
Last updated
01/31/2025
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