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Individual

JAMIE V DAVIDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2500 N STATE ST. UNIVERSITY PHYSICIANS, DEPARTMENT OF MEDICINE DIVISION OF NEPHROLOGY, JACKSON, MS 39216-4500
(601) 984-5681
Mailing address
2500 NORTH STATE STREET, UNIVERSITY PHYSICIANS, JACKSON, MS 39216
(601) 984-5681
(601) 984-6439

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R852167
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06772519
MS
05
139491
MS
Enumeration date
07/09/2012
Last updated
04/09/2014
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