Provider Demographics
NPI:1881839967
Name:DAVIS, JULIE ANNETTE (RN CSN)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANNETTE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN CSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4735 W MORTEN AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-1560
Mailing Address - Country:US
Mailing Address - Phone:623-707-2103
Mailing Address - Fax:623-707-2204
Practice Address - Street 1:4735 W MORTEN AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-1560
Practice Address - Country:US
Practice Address - Phone:623-707-2103
Practice Address - Fax:623-707-2204
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN069064163WP0200X
AZSN0967163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WP0200XNursing Service ProvidersRegistered NursePediatrics