Provider Demographics
NPI:1801371562
Name:DAVIS, ANN RENEE (LPN)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:RENEE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:RENEE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:286 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16125-1859
Mailing Address - Country:US
Mailing Address - Phone:724-301-6341
Mailing Address - Fax:
Practice Address - Street 1:3676 N HERMITAGE RD
Practice Address - Street 2:
Practice Address - City:TRANSFER
Practice Address - State:PA
Practice Address - Zip Code:16154-1852
Practice Address - Country:US
Practice Address - Phone:330-726-0700
Practice Address - Fax:330-726-1114
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN073069L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse