Provider Demographics
NPI:1477170181
Name:DAVIES, ELIZA SOWULUE (BSN, RN, BSBA)
Entity Type:Individual
Prefix:
First Name:ELIZA
Middle Name:SOWULUE
Last Name:DAVIES
Suffix:
Gender:F
Credentials:BSN, RN, BSBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 S WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-6875
Mailing Address - Country:US
Mailing Address - Phone:817-905-7596
Mailing Address - Fax:
Practice Address - Street 1:418 S WILLOW ST
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-6875
Practice Address - Country:US
Practice Address - Phone:817-905-7596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX772278163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty