Provider Demographics
NPI:1851093934
Name:DAVIS, NATHALIE CULLEN (RN)
Entity Type:Individual
Prefix:
First Name:NATHALIE
Middle Name:CULLEN
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 1:4289 W 1275 S
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-4693
Mailing Address - Country:US
Mailing Address - Phone:435-592-2621
Mailing Address - Fax:
Practice Address - Street 1:2077 W ROYAL HUNTE DR
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-1883
Practice Address - Country:US
Practice Address - Phone:435-586-2804
Practice Address - Fax:435-586-2815
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7218913-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse