Provider Demographics
NPI:1235712654
Name:DAVIS, DONNA CHRISTINE (PA-S)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:CHRISTINE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 OLD BRICK RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-5833
Mailing Address - Country:US
Mailing Address - Phone:910-583-6036
Mailing Address - Fax:
Practice Address - Street 1:1907 OLD BRICK RD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-5833
Practice Address - Country:US
Practice Address - Phone:910-583-6036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant