Provider Demographics
NPI:1447432976
Name:DAVIS, DEBRA F (DC & ACUPUNCTURIST)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:F
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DC & ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 UNIVERSITY DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-4169
Mailing Address - Country:US
Mailing Address - Phone:701-232-4922
Mailing Address - Fax:
Practice Address - Street 1:1515 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-4169
Practice Address - Country:US
Practice Address - Phone:701-232-4922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND437111N00000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND4328OtherBLUECROSSBLUESHEILD
ND15199Medicaid
NDN4328Medicare PIN