Provider Demographics
NPI:1225896608
Name:DAVIS, WENDY DANIELLE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:DANIELLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:WENDY
Other - Middle Name:DANIELLE
Other - Last Name:ECKL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1910 COUNTY FARM RD
Mailing Address - Street 2:
Mailing Address - City:TUSCUMBIA
Mailing Address - State:AL
Mailing Address - Zip Code:35674-5826
Mailing Address - Country:US
Mailing Address - Phone:256-415-1386
Mailing Address - Fax:
Practice Address - Street 1:102 PHYSICIANS DR STE A
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2149
Practice Address - Country:US
Practice Address - Phone:256-286-4026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-130731363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily