Individual
JACOB A DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1755 N MECKLENBURG AVE, SOUTH HILL, VA 23970-4080
(434) 447-3151
Mailing address
PO BOX 780125, PHILADELPHIA, PA 19178-0125
(804) 922-4844
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024175305
VA
367500000X
Certified Registered Nurse Anesthetist
RN114748
LA
Other
Enumeration date
01/10/2013
Last updated
02/16/2026
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