Davenport, Marion

Davenport, Marion is an individual health care provider with primary practice located at 720 E New Haven Avenue , Melbourne FL 32901. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Davenport, Marion can be contacted via phone (321) 724-4545.

Contact Information

Primary practice address
720 E New Haven Avenue Melbourne FL 32901
Phone: (321) 724-4545
Fax: (321) 728-4168
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X ARNP1415672 Florida

Profile Details

NPI number 1053376723
LBN Legal business name Davenport, Marion
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Jul 1st, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053376723 NPPES
Florida MEDICAID 303140300

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