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
Fax: (309) 692-2804
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164561130 NPPES
Illinois MEDICAID 209006059

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