Provider Demographics
NPI:1063206951
Name:DAVIS, TRIQUANA SPRINGS
Entity type:Individual
Prefix:
First Name:TRIQUANA
Middle Name:SPRINGS
Last Name:DAVIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 WATERWORKS RD STE A
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-1958
Mailing Address - Country:US
Mailing Address - Phone:336-277-5090
Mailing Address - Fax:
Practice Address - Street 1:NOVANT HEALTH WINSTON LAKE FAMILY MEDICINE
Practice Address - Street 2:901 WATERWORKS RD SUITE A
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101
Practice Address - Country:US
Practice Address - Phone:336-277-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5021936363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily