Provider Demographics
NPI:1518736214
Name:DAVIS, MERCEDES (FNP)
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 N AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:COMANCHE
Mailing Address - State:TX
Mailing Address - Zip Code:76442-2408
Mailing Address - Country:US
Mailing Address - Phone:325-356-1135
Mailing Address - Fax:325-356-1145
Practice Address - Street 1:408 N AUSTIN ST
Practice Address - Street 2:
Practice Address - City:COMANCHE
Practice Address - State:TX
Practice Address - Zip Code:76442-2408
Practice Address - Country:US
Practice Address - Phone:325-356-1135
Practice Address - Fax:325-356-1145
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1145816363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily