Provider Demographics
NPI:1427386127
Name:DAVIS, KAREN NELSON (RN)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:NELSON
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:NELSON
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:20 W BANK ST
Mailing Address - Street 2:PETERSBURG
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-3279
Mailing Address - Country:US
Mailing Address - Phone:804-276-3882
Mailing Address - Fax:
Practice Address - Street 1:9149 CHATHAM GROVE LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23236-1163
Practice Address - Country:US
Practice Address - Phone:804-276-3882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001102546163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult