Provider Demographics
NPI:1447801469
Name:DAVIS, NANCY KAY
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:KAY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 FORGET ME NOT DRIVE
Mailing Address - Street 2:
Mailing Address - City:WHITE POST
Mailing Address - State:VA
Mailing Address - Zip Code:22663-1887
Mailing Address - Country:US
Mailing Address - Phone:304-573-3067
Mailing Address - Fax:540-508-0102
Practice Address - Street 1:112 FORGET ME NOT DRIVE
Practice Address - Street 2:
Practice Address - City:WHITE POST
Practice Address - State:VA
Practice Address - Zip Code:22663-1887
Practice Address - Country:US
Practice Address - Phone:304-573-3067
Practice Address - Fax:540-508-0102
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider