Basic Information
Provider Information
NPI: 1003802083
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAVIS
FirstName: NOVLET
MiddleName: JARRETT
NamePrefix: MRS.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5109 SUNSET FAIRWAYS DR
Address2:  
City: HOLLY SPRINGS
State: NC
PostalCode: 275407862
CountryCode: US
TelephoneNumber: 3367402160
FaxNumber: 9194431268
Practice Location
Address1: 875 WALNUT ST # 275-9
Address2:  
City: CARY
State: NC
PostalCode: 275114215
CountryCode: US
TelephoneNumber: 9197496288
FaxNumber: 9194431268
Other Information
ProviderEnumerationDate: 09/23/2005
LastUpdateDate: 06/08/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X200400131NCY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
80842701NCPARTNERSOTHER
18881301NCMEDCOSTOTHER
143MM01NCBCBS OF NCOTHER
590367405NC MEDICAID


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