Basic Information
| Provider Information | |||||||||
| NPI: | 1003802083 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAVIS | ||||||||
| FirstName: | NOVLET | ||||||||
| MiddleName: | JARRETT | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| 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 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 200400131 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 143MM | 01 | NC | BCBS OF NC | OTHER | 5903674 | 05 | NC | MEDICAID | 188813 | 01 | NC | MEDCOST | OTHER | 808427 | 01 | NC | PARTNERS | OTHER |