Individual
MS. JILL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
DUMC 3158, DURHAM, NC 27710-0001
(919) 684-5118
(919) 668-1559
Mailing address
DUMC 3158, DURHAM, NC 27710-0001
(919) 684-5118
(919) 668-1559
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-01654
NC
363A00000X
Physician Assistant
085-002554
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109260
HAMP INS. #
IL
01
—
3932056
BCBS
IL
01
—
7210895
AETNA
IL
01
—
733354
HEALTHLINK
IL
Enumeration date
12/28/2006
Last updated
05/05/2009
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