Provider Demographics
NPI:1588913958
Name:DAVIS, ABIGAIL E (CNP)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:E
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0449
Mailing Address - Country:US
Mailing Address - Phone:740-374-4500
Mailing Address - Fax:740-374-5887
Practice Address - Street 1:304 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:OH
Practice Address - Zip Code:43724-1322
Practice Address - Country:US
Practice Address - Phone:740-732-2339
Practice Address - Fax:740-732-2350
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-31
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.13643-NP363LF0000X
OHRN.333859363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0071578Medicaid
OHP01289248OtherRAILROAD MEDICARE - MHCPI
WV3810024368Medicaid
WV3810024368Medicaid