Provider Demographics
NPI:1023155298
Name:DAVIS, GLORI JANET
Entity type:Individual
Prefix:MRS
First Name:GLORI
Middle Name:JANET
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12180 ROSEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-2374
Mailing Address - Country:US
Mailing Address - Phone:910-277-2563
Mailing Address - Fax:910-277-2564
Practice Address - Street 1:1112 ATKINSON ST
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-4723
Practice Address - Country:US
Practice Address - Phone:910-277-2563
Practice Address - Fax:910-277-2564
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3328163WC1600X, 163WH0200X, 3747A0650X, 3747P1801X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
Not Answered163WH0200XNursing Service ProvidersRegistered NurseHome Health
Not Answered3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Not Answered3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Not Answered376K00000XNursing Service Related ProvidersNurse's Aide