Provider Demographics
NPI:1225702889
Name:DAVIS, JAY D (FNP-C)
Entity type:Individual
Prefix:MR
First Name:JAY
Middle Name:D
Last Name:DAVIS
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1800 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-6701
Mailing Address - Country:US
Mailing Address - Phone:814-231-7100
Mailing Address - Fax:814-238-0790
Practice Address - Street 1:2505 GREEN TECH DR STE C
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2316
Practice Address - Country:US
Practice Address - Phone:844-237-6600
Practice Address - Fax:814-234-7587
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP023380363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily