Provider Demographics
NPI:1851048573
Name:DAVIS, KATHARINE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 BELMONT CT E
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-4863
Mailing Address - Country:US
Mailing Address - Phone:716-418-4367
Mailing Address - Fax:
Practice Address - Street 1:263 BELMONT CT E
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-4863
Practice Address - Country:US
Practice Address - Phone:716-418-4367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY315324-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health