Provider Demographics
NPI:1255858718
Name:DAVY, NICOLE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:DAVY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1392A TALBERT CT SE UNIT A
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-5205
Mailing Address - Country:US
Mailing Address - Phone:646-528-0161
Mailing Address - Fax:
Practice Address - Street 1:800 21ST ST NW FL GROUND
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20052-0028
Practice Address - Country:US
Practice Address - Phone:202-994-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1031107363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily