Provider Demographics
NPI:1053784587
Name:DAVY, MARLA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:
Last Name:DAVY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 BELFORT RD STE 130
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6018
Mailing Address - Country:US
Mailing Address - Phone:904-446-3781
Mailing Address - Fax:903-463-0011
Practice Address - Street 1:2600 N SAM RAYBURN FWY
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-0500
Practice Address - Country:US
Practice Address - Phone:903-416-3650
Practice Address - Fax:903-416-3651
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128318363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily