Provider Demographics
NPI:1659404234
Name:DAVIS, DIONE C (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:DIONE
Middle Name:C
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 S LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:RANSOM CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79366-2409
Mailing Address - Country:US
Mailing Address - Phone:806-748-3878
Mailing Address - Fax:
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:DEPT. OF PEDIATRICS
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:806-743-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX638677363LP0200X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics