Provider Demographics
NPI:1164537924
Name:DAVIS, ESTHER LYNN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:LYNN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:LYNN
Other - Last Name:DOLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16007 S 38TH WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-7376
Mailing Address - Country:US
Mailing Address - Phone:480-759-5663
Mailing Address - Fax:602-424-2103
Practice Address - Street 1:731 E HEARN RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-4329
Practice Address - Country:US
Practice Address - Phone:602-424-2101
Practice Address - Fax:602-424-2103
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2314363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZQ68619Medicare UPIN