Provider Demographics
NPI:1851632921
Name:DAVIS, PAMELA E (FNP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:E
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 ENGLEWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-0872
Mailing Address - Country:US
Mailing Address - Phone:513-667-6358
Mailing Address - Fax:
Practice Address - Street 1:5205 ENGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:LIBERTY TWP
Practice Address - State:OH
Practice Address - Zip Code:45011-1163
Practice Address - Country:US
Practice Address - Phone:513-667-6358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH385184163W00000X
OHLE-00020251363LF0000X
OH021171363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse