Provider Demographics
NPI:1073556858
Name:DAVIS, SANDY LYNN (NP)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:LYNN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1701 WESTCHESTER DRIVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2400
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:1814 WESTCHESTER DR
Practice Address - Street 2:STE 301
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7369
Practice Address - Country:US
Practice Address - Phone:336-802-2588
Practice Address - Fax:336-802-2340
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2009-10-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC900396363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2809142Medicare PIN
P94160Medicare UPIN
NC2809142AMedicare PIN