Provider Demographics
NPI:1962058867
Name:DAVIS, CHRISTOPHER CHASE (NP-C)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:CHASE
Last Name:DAVIS
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-3630
Mailing Address - Country:US
Mailing Address - Phone:931-424-9797
Mailing Address - Fax:931-424-9788
Practice Address - Street 1:2019 N LOCUST AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-2337
Practice Address - Country:US
Practice Address - Phone:931-762-1800
Practice Address - Fax:931-762-9155
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26381363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF08190106OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS NATIONAL CERTIFICATION BOARD, INC.
TNQ054852Medicaid