Individual
MARTHA DAVAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
6202 N 9TH AVE STE 4, PENSACOLA, FL 32504-8291
(832) 485-4976
Mailing address
2260 PINE NEEDLES CIR, PENSACOLA, FL 32514-5632
(850) 393-0951
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11007867
FL
363LG0600X
Gerontology Nurse Practitioner
APRN11007867
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN11007867
STATE OF FLORIDA
FL
Enumeration date
08/04/2020
Last updated
09/21/2023
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