Provider Demographics
NPI:1437228780
Name:DAVIS, NELL L (MD)
Entity Type:Individual
Prefix:
First Name:NELL
Middle Name:L
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5161 E ARAPAHOE RD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-4810
Mailing Address - Country:US
Mailing Address - Phone:720-488-0055
Mailing Address - Fax:720-488-3955
Practice Address - Street 1:5161 E ARAPAHOE RD
Practice Address - Street 2:SUITE 290
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-4810
Practice Address - Country:US
Practice Address - Phone:720-488-0055
Practice Address - Fax:720-488-3955
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2013-05-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO27533207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01275338Medicaid
COE34655Medicare UPIN
CO01275338Medicaid