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MRS. DALLAS JORDAN DAVIS PROVENCE NP NPI 1619556230


NPI Information

NPI: 1619556230
Provider Name: MRS. DALLAS JORDAN DAVIS PROVENCE, NP
Classification: Dermatology - 207ND0900X
Entity Type: Individual

Specialization: Dermatopathology

PECOS Registration: Yes

Address:
6254 POPLAR AVE
MEMPHIS, TN
ZIP 38119
Phone: (901) 624-3333
Get Directions

MRS. Dallas Jordan Davis Provence, NP is a dermatopathology dermatology in Memphis, TN with 4 years of experience. The provider is a dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. MRS. Dallas Jordan Davis Provence, NP NPI is 1619556230. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6254 POPLAR AVE
MEMPHIS, TN
ZIP 38119-713
Phone: (901) 624-3333

The NPI 1619556230 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/2/2021 and was last updated on 4/2/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0900XDermatologyDermatopathology28973TENNESSEEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.