Provider Demographics
NPI:1568692416
Name:DAVIS, NANCY MICHELLE (RN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:MICHELLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 NORMANDY DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-9202
Mailing Address - Country:US
Mailing Address - Phone:614-572-6162
Mailing Address - Fax:740-348-5962
Practice Address - Street 1:1214 NORMANDY DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-9202
Practice Address - Country:US
Practice Address - Phone:614-572-6162
Practice Address - Fax:740-348-5962
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 347271163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse