Individual
DR. JENNIFER DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1821 S WEBSTER AVE, GREEN BAY, WI 54301-2253
(920) 496-4700
Mailing address
1821 S WEBSTER AVE, GREEN BAY, WI 54301-2253
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01080544A
IN
207R00000X
Internal Medicine Physician
2012018501
MO
207RC0000X
Cardiovascular Disease Physician
01080544A
IN
207RC0000X
Cardiovascular Disease Physician
036.150159
IL
207RC0000X
Cardiovascular Disease Physician
MD.207877
LA
207RI0011X
Interventional Cardiology Physician
Primary
036.150159
IL
Other
Enumeration date
06/20/2012
Last updated
06/22/2021
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