NPI 1063529162

Jack Mathew Davis, FNP

Practitioner Family Nurse Practitioner Apo, AP

Practice location

Address: 18th Medcom Attn: Dccs-Qm (credentials), Apo, AP 96205-0054
Phone: 01182279166027
Fax: 01182279178110
Mailing address: 3523 Trailway Park St, San Antonio, TX 78247-2927

Registered specialties

Family Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LF0000X Licence RN073330 (AZ)

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Registry record

NPI: 1063529162
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Aug 2006
Record last updated: 21 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.