KAITLYN RENEE DAVIDSON (NPI# 1285184713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285184713 |
| Entity Type | Individual |
| Full Name | KAITLYN RENEE DAVIDSON |
| Credential | NP-C |
| Practice Address |
15 Founders Ln Jacksonville IL 62650 |
| Mailing Address |
1025 S 6th St Springfield IL 62703-2499 |
| Practice Telephone | 2175287541 |
| Practice Fax Number | 2172433658 |
| Mailing Telephone | 2175287541 |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2020-05-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209014951 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1600 W Walnut St, Jacksonville, IL 626501136 | 2172459541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204640 | Kaitlyn Renea Davidson | Nurse Practitioner | 3304 Cooley Ct, Portage, MI 49024-7430 | 2020-10-30 |
| 1013551647 | Kaitlyn Davidson | Registered Nurse | 1211 Medical Center Dr, Nashville, TN 37232-0004 | 2019-11-06 |
| 1649641622 | Kaitlyn Davidson | Case Manager/Care Coordinator | 101 Klothe Dr, Grahamsville, NY 12740-5805 | 2015-10-15 |
| Street Address |
15 FOUNDERS LN |
| City | JACKSONVILLE |
| State | IL |
| Zip Code | 62650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487609640 | Kim Wyatt | Family Medicine | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2006-05-24 |
| 1144850769 | Melinda J Dorsey | Registered Nurse | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2020-01-23 |
| 1578115390 | Doug R Mckain | Nurse Practitioner | 15 Founders Ln, Jacksonville, IL 62650 | 2019-07-11 |
| 1265901227 | Lisa J. Lyons | Physician Assistant | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2018-11-20 |
| 1528518602 | Agnes A. Fenner | Nurse Practitioner | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2016-10-12 |
| 1538518709 | Natalie Mahoney | Family Medicine | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2016-06-08 |
| 1194196493 | Molly Taylor | Nurse Practitioner | 15 Founders Ln, Suite 100, Jacksonville, IL 62650-3919 | 2015-10-13 |
| 1497131072 | Braden G. Anderson | Optometrist | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2015-08-05 |
| 1083020903 | Coral Jeanne Armour | Social Worker | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2014-07-11 |
| 1326458332 | Mosam B Patel | Family Medicine | 15 Founders Ln, Jacksonville, IL 62650-3919 | 2014-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
| 1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
| 1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
| 1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
| 1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
| 1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
| 1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
| 1740350529 | Susan Weller | Dentist | 1614 West Lafayette Avenue, Jackson, IL 62650 | 2006-11-08 |
| 1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
| 1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
| Find all providers in zip 62650 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293868 | Maria Fe Guboc Rufano-sulit | Nurse Practitioner | 3682 Summerlin Ln, Jacksonville, FL 32224-1650 | 2020-10-21 |
| 1346849502 | Caitlin Flott | Nurse Practitioner | 14589 Camberwell Ln S, Jacksonville, FL 32258-1708 | 2020-10-20 |
| 1972101137 | Amanda Brooke Mills | Nurse Practitioner | 8459 Oak Crossing Dr W, Jacksonville, FL 32244-6949 | 2020-10-10 |
| 1649877200 | Shalom Barile | Nurse Practitioner | 1377 Ingleside Ave, Jacksonville, FL 32205-7733 | 2020-10-07 |
| 1013524248 | Claudia Joseph | Nurse Practitioner | 3331 Net Ct, Jacksonville, FL 32277-2735 | 2020-10-01 |
| 1063029577 | Erica Francisca Andrade | Nurse Practitioner | 5475 Turkey Creek Rd, Jacksonville, FL 32244-8549 | 2020-09-29 |
| 1568078418 | Jennifer Ruth Woodard | Nurse Practitioner | 29 Trinity Way, Jacksonville, AL 36265-5813 | 2020-09-16 |
| 1013522309 | William David Michal | Nurse Practitioner | 4417 Chippewa Dr, Jacksonville, FL 32210-6006 | 2020-09-13 |
| 1063025906 | Fabiola Baptiste | Nurse Practitioner | 9143 Philips Hwy Ste 110, Jacksonville, FL 32256-1365 | 2020-08-29 |
| 1295348464 | Debi Cohen | Nurse Practitioner | 11266 Cloverhill Ct, Jacksonville, FL 32257-1438 | 2020-08-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 62650 |
Please comment or provide details below to improve the information on KAITLYN RENEE DAVIDSON.
| 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.