Individual
JOHN WESLEY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
655 W 8TH ST, UFJAX - DEPT. OF ANESTHESIOLOGY, JACKSONVILLE, FL 32209-6511
(904) 244-4195
(904) 244-4908
Mailing address
PO BOX 44008, UFJP - PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3199
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP3213442
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003107187A
—
GA
05
—
0033548-00
—
FL
Enumeration date
03/22/2011
Last updated
05/12/2011
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