Provider Demographics
NPI:1548576531
Name:DAVIS, KATIE M (FNP-C)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:M
Other - Last Name:SCHOLLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7631 CHEVIOT RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-4012
Mailing Address - Country:US
Mailing Address - Phone:513-923-1886
Mailing Address - Fax:513-923-2878
Practice Address - Street 1:7631 CHEVIOT RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-4012
Practice Address - Country:US
Practice Address - Phone:513-923-1886
Practice Address - Fax:513-923-2878
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004823A363LF0000X
OHAPRN.CNP.11823363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201125500Medicaid