Provider Demographics
NPI:1164718003
Name:DAVIS, NANCY B (ACNS)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:B
Last Name:DAVIS
Suffix:
Gender:F
Credentials:ACNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 N FIELDER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4636
Mailing Address - Country:US
Mailing Address - Phone:817-277-2671
Mailing Address - Fax:817-460-3004
Practice Address - Street 1:707 N FIELDER RD
Practice Address - Street 2:SUITE A
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4636
Practice Address - Country:US
Practice Address - Phone:817-277-2671
Practice Address - Fax:817-460-3004
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP119984364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX283648802Medicaid
TX283648803Medicaid
TX283648803Medicaid
TX283648802Medicaid
TXTXB132991Medicare PIN