Davis, Amy Marie
Davis, Amy Marie is an sole proprietor health care provider with primary practice located at 5401 N Knoxville Ave Ste 207 , Peoria IL 61614-5021. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as her primary health care specialty. Davis, Amy Marie can be contacted via phone (309) 692-0400.Contact Information
Primary practice address
5401 N Knoxville Ave Ste 207
Peoria IL 61614-5021
Phone: (309) 692-0400
Fax: (309) 692-2804
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | 209006059 | Illinois |
Profile Details
| NPI number | 1164561130 |
|---|---|
| LBN Legal business name | Davis, Amy Marie |
| Credentials | APN FNP-C |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 6th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164561130 | NPPES |
| Illinois | MEDICAID | 209006059 |
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