Provider Demographics
NPI:1386864437
Name:DAVIS, KAREN ANN
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:ANN
Other - Last Name:CANNON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8548 CROSS POINTE LOOP
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504
Mailing Address - Country:US
Mailing Address - Phone:907-646-9998
Mailing Address - Fax:
Practice Address - Street 1:9210 JUPITER DRIVE
Practice Address - Street 2:DAY BREAK ADULT DAY CENTER
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507
Practice Address - Country:US
Practice Address - Phone:907-346-2234
Practice Address - Fax:907-346-2601
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician