Individual
JENNIFER L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6160 S YALE AVE, TULSA, OK 74136-1930
(918) 495-2600
(918) 497-3007
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1007
OK
363A00000X
Physician Assistant
PA9107151
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376528901
—
NV
01
—
P00946910
RAILROAD PTAN
NV
01
—
V113936
SMA MEDICARE
NV
Enumeration date
12/06/2005
Last updated
04/02/2020
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