Provider Demographics
NPI:1508879271
Name:DAVIS, LILLIAN FRANCES (NNP)
Entity Type:Individual
Prefix:MRS
First Name:LILLIAN
Middle Name:FRANCES
Last Name:DAVIS
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 N VISTA BONITA
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-8518
Mailing Address - Country:US
Mailing Address - Phone:435-986-1945
Mailing Address - Fax:
Practice Address - Street 1:653 N TOWN CENTER DR
Practice Address - Street 2:STE 10
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0514
Practice Address - Country:US
Practice Address - Phone:702-733-0981
Practice Address - Fax:702-733-9752
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2011-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN000875363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal