Davis, Jacqueline Smith
Davis, Jacqueline Smith is an individual health care provider with primary practice located at 2001 Todays Woman Ave , Winston Salem NC 27105-5069. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Davis, Jacqueline Smith can be contacted via phone (336) 722-1818.Contact Information
Primary practice address
2001 Todays Woman Ave
Winston Salem NC 27105-5069
Phone: (336) 722-1818
Fax: (336) 722-1826
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 104882 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 5001629 | North Carolina |
Profile Details
| NPI number | 1891840120 |
|---|---|
| LBN Legal business name | Davis, Jacqueline Smith |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 25th, 2007 |
| Last updated | May 8th, 2024 - about 2 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 | 1891840120 | NPPES |
| North Carolina | Other | 196292 | MEDCOST |
| North Carolina | Other | NN2912 | MEDCOST |
| North Carolina | Other | 9185097 | MEDCOST |
| North Carolina | Other | 181GT | MEDCOST |
| North Carolina | MEDICAID | 7003982 | MEDCOST |
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