Provider Demographics
NPI:1508845538
Name:DAVIS, PAMELA CARTER (APN)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:CARTER
Last Name:DAVIS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 DR. D. B. TODD BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208
Mailing Address - Country:US
Mailing Address - Phone:615-327-5524
Mailing Address - Fax:615-327-5541
Practice Address - Street 1:1005 DR. D. B. TODD BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208
Practice Address - Country:US
Practice Address - Phone:615-327-5524
Practice Address - Fax:615-327-5541
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN135639163WR1000X
TN8290363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163WR1000XNursing Service ProvidersRegistered NurseReproductive Endocrinology/Infertility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3929805Medicaid
TNQ23772Medicare UPIN
TN3929805Medicare ID - Type Unspecified