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Contact Information

JACQUELINE E DAVIS, PA-C
3 AUDUBON PLAZA DR STE 430
LOUISVILLE, KY40217
 Phone: 502-636-4900
 Fax: 502-636-4901
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for JACQUELINE E DAVIS · (Female)

NPI # 1245402262
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 03/31/2008
Last updated 03/21/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • KY Medicaid 7100054590
  • KY Other 50022601 PASSPORT HEALTH PLAN
Hospital affiliation(s)
  • NORTON HOSPITALS INC - (Acute Care)
    200 EAST CHESTNUT STREET
    LOUISVILLE, KY 40202
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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