Provider Demographics
NPI:1306493424
Name:DAVIS, PINKARN
Entity type:Individual
Prefix:
First Name:PINKARN
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 LANE DR
Mailing Address - Street 2:
Mailing Address - City:ALLENSTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03275-2249
Mailing Address - Country:US
Mailing Address - Phone:603-534-1446
Mailing Address - Fax:
Practice Address - Street 1:17 LANE DR
Practice Address - Street 2:
Practice Address - City:ALLENSTOWN
Practice Address - State:NH
Practice Address - Zip Code:03275-2249
Practice Address - Country:US
Practice Address - Phone:603-534-1446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-22
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider