Provider Demographics
NPI:1437407889
Name:DAVIS, EILEEN REBECCA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:REBECCA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 W BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:BARTO
Mailing Address - State:PA
Mailing Address - Zip Code:19504-9226
Mailing Address - Country:US
Mailing Address - Phone:610-845-8465
Mailing Address - Fax:
Practice Address - Street 1:132 W BRANCH RD
Practice Address - Street 2:
Practice Address - City:BARTO
Practice Address - State:PA
Practice Address - Zip Code:19504-9226
Practice Address - Country:US
Practice Address - Phone:610-845-8465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN080527L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse