Provider Demographics
NPI:1326205204
Name:DAVENPORT, EMILY (NMD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 N HUMPHREYS ST
Mailing Address - Street 2:BLDG. 9, STE 135
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3027
Mailing Address - Country:US
Mailing Address - Phone:928-774-1770
Mailing Address - Fax:
Practice Address - Street 1:809 N HUMPHREYS ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3027
Practice Address - Country:US
Practice Address - Phone:928-774-1770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ08-1065175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath