Provider Demographics
NPI:1992417919
Name:DAVIS, REBECCA F
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:F
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 1:4848 UPPER OBRIEN RD
Mailing Address - Street 2:
Mailing Address - City:FRAMETOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26623-6821
Mailing Address - Country:US
Mailing Address - Phone:304-644-5518
Mailing Address - Fax:
Practice Address - Street 1:4848 UPPER OBRIEN RD
Practice Address - Street 2:
Practice Address - City:FRAMETOWN
Practice Address - State:WV
Practice Address - Zip Code:26623-6821
Practice Address - Country:US
Practice Address - Phone:304-644-5518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV45688163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse