AMANDA MARIE DAVIS (NPI# 1700401908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700401908 |
| Entity Type | Individual |
| Full Name | AMANDA MARIE DAVIS |
| Credential | AGACNP-BC |
| Practice Address |
2751 Albert L Bicknell Dr Ste 5c Shreveport LA 71103-3943 |
| Practice Telephone | 3182279777 |
| Mailing Telephone | 3182279777 |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2020-06-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
213735 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
213735 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
213735 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194330423 | Amanda Nicole Davis | Nurse's Aide | 686 Easy St, Marion, OH 43302-1606 | 2020-09-14 |
| 1598318842 | Amanda Lee Davis | Speech-Language Pathologist | 5730 W Centinela Ave Apt 308, Los Angeles, CA 90045-8815 | 2019-07-16 |
| 1790245645 | Amanda Davis | Occupational Therapy Assistant | 22461 Interstate 30 Ste 301, Bryant, AR 72022-2382 | 2019-03-25 |
| 1295246007 | Amanda N. Davis | Marriage & Family Therapist | 5001 Kendall Sta Nw, Acworth, GA 30102-7961 | 2017-10-19 |
| 1558886598 | Amanda Marie Davis | Nurse Practitioner | 18500 E 6th Ave, Aurora, CO 80011-9504 | 2017-08-10 |
| 1386184638 | Amanda Jean Davis | Behavioral Analyst | 34 Manor House Rd, Budd Lake, NJ 07828-2718 | 2017-03-06 |
| 1427593946 | Amanda Jane Davis | Social Worker | 5520 Barton Ln, Shawnee, KS 66203-2246 | 2016-12-20 |
| 1972054013 | Amanda Lee Davis | Hearing Instrument Specialist | 1761 Lisbon St, Unit 2, Lewiston, ME 04240-3525 | 2016-10-24 |
| 1033506209 | Amanda Davis | Social Worker | 7863 Park Gate Dr, North Charleston, SC 29418-3687 | 2015-04-24 |
| 1891192985 | Amanda Kathleen Davis | Nurse Practitioner | 4302 Allen Rd Ste 420, Stow, OH 44224-1070 | 2014-12-04 |
| Street Address |
2751 ALBERT L BICKNELL DR STE 5C |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-3943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790228013 | Brian Keith Fontenot | Physician Assistant | 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 | 2016-11-18 |
| 1609474428 | Thea Christine Fontenot | Physician Assistant | 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 | 2020-10-14 |
| 1437774635 | April Chase | Nurse Practitioner | 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 | 2020-06-12 |
| 1275011256 | Amy Fontenot | Physician Assistant | 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103 | 2018-08-01 |
| 1386137586 | Emily Leanne Welch | Nurse Practitioner | 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 | 2018-06-12 |
| 1194243899 | Serena Shah Frye | Physician Assistant | 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 | 2017-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
| 1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
| 1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
| 1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
| 1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
| 1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| Find all providers in zip 71103 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293355 | Sheronica V Simmons | Nurse Practitioner | 2751 Albert L Bicknell Dr Ste 3c, Shreveport, LA 71103-3943 | 2020-10-25 |
| 1316410236 | Tanya Nicole Slayter | Nurse Practitioner | 1811 E Bert Koun Loop Ste 210, Shreveport, LA 71105-5740 | 2019-01-03 |
| 1679061279 | Antonya Williams | Nurse Practitioner | 9419 Amity Way, Shreveport, LA 71118-3601 | 2018-04-29 |
| 1922475227 | Dillon Hart Acnp, LLC | Nurse Practitioner | 5021 Beechwood Hills Dr, Shreveport, LA 71107-9175 | 2015-08-22 |
| 1487066296 | Alfred W. Hathorn Jr., M.d. Apmc | Nurse Practitioner | 2120 Bert Koun Loop, Suite # L, Shreveport, LA 71118-3351 | 2014-05-28 |
| 1427675701 | Lakyn Paige Smith | Nurse Practitioner | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2020-07-02 |
| 1437774635 | April Chase | Nurse Practitioner | 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 | 2020-06-12 |
| 1215560578 | Benjamin Potter | Nurse Practitioner | 1800 Irving Pl, Shreveport, LA 71101-4608 | 2020-02-14 |
| 1922653443 | Tarcariyunn Shantay Caldwell | Nurse Practitioner | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2019-08-02 |
| 1831742147 | Christina Marie Simpkins | Nurse Practitioner | 1453 E Bert Koun Loop Ste 112, Shreveport, LA 71105-6810 | 2019-07-17 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
Please comment or provide details below to improve the information on AMANDA MARIE DAVIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.