Provider Demographics
NPI:1083634810
Name:DAVIS, NANCY B (RN WHNP)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:B
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN WHNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13109 CHANCERY PL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7511
Mailing Address - Country:US
Mailing Address - Phone:804-360-7167
Mailing Address - Fax:804-556-5843
Practice Address - Street 1:GOOCHLAND HEALTH DEPT
Practice Address - Street 2:
Practice Address - City:GOOCHLAND
Practice Address - State:VA
Practice Address - Zip Code:23063
Practice Address - Country:US
Practice Address - Phone:804-360-7167
Practice Address - Fax:804-556-5843
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01024074640363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NPP000Medicare UPIN