Provider Demographics
NPI:1417373325
Name:DAVIS, VANNESSA (DNP, FNP, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:VANNESSA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DNP, FNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 STILES RD
Mailing Address - Street 2:STE 210
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2853
Mailing Address - Country:US
Mailing Address - Phone:603-601-4766
Mailing Address - Fax:603-506-6362
Practice Address - Street 1:23 STILES RD
Practice Address - Street 2:STE 210
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2853
Practice Address - Country:US
Practice Address - Phone:603-601-4766
Practice Address - Fax:603-506-6362
Is Sole Proprietor?:No
Enumeration Date:2014-03-16
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH076708-23363LF0000X, 363LP0808X
IL209011367363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily