Provider Demographics
NPI:1821301656
Name:DAVIS, ALICIA LOUISE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:LOUISE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:ALICIA
Other - Middle Name:LOUISE
Other - Last Name:BOOKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:99 CLAREMONT AVE APT 514
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-5707
Mailing Address - Country:US
Mailing Address - Phone:513-252-1262
Mailing Address - Fax:
Practice Address - Street 1:99 CLAREMONT AVE APT 514
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-5707
Practice Address - Country:US
Practice Address - Phone:513-252-1262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH325063163W00000X
NY619235-1163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163W00000XNursing Service ProvidersRegistered Nurse