Provider Demographics
NPI:1326783150
Name:DAVIS, HANNA NIKOLE (DC)
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:NIKOLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:OGALLALA
Mailing Address - State:NE
Mailing Address - Zip Code:69153-2530
Mailing Address - Country:US
Mailing Address - Phone:308-212-0417
Mailing Address - Fax:
Practice Address - Street 1:106 W 1ST ST
Practice Address - Street 2:
Practice Address - City:OGALLALA
Practice Address - State:NE
Practice Address - Zip Code:69153-2530
Practice Address - Country:US
Practice Address - Phone:308-212-0417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2131111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor