Provider Demographics
NPI:1891874434
Name:CROSS-DAVIS, RENE' L (ARNP)
Entity type:Individual
Prefix:MRS
First Name:RENE'
Middle Name:L
Last Name:CROSS-DAVIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:RENE'
Other - Middle Name:L
Other - Last Name:CROSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:706 COLUMBIA HWY
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:42743-1118
Mailing Address - Country:US
Mailing Address - Phone:270-299-2286
Mailing Address - Fax:270-299-2157
Practice Address - Street 1:706 COLUMBIA HWY
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:KY
Practice Address - Zip Code:42743-1118
Practice Address - Country:US
Practice Address - Phone:270-299-2286
Practice Address - Fax:270-299-2157
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4756P363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY11453123OtherCAQH
KY1086330OtherREGISTERED NURSE
KY4756POtherNURSE PRACTITIONER
KY78015989Medicaid
KY00652004Medicare PIN
KY78015989Medicaid