Provider Demographics
NPI:1023665015
Name:DAVIS, MEGAN CAROLINE (RN, BSN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:CAROLINE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13903-1645
Mailing Address - Country:US
Mailing Address - Phone:607-763-5742
Mailing Address - Fax:607-723-3496
Practice Address - Street 1:93 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-1645
Practice Address - Country:US
Practice Address - Phone:607-763-5742
Practice Address - Fax:607-723-3496
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY590945163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator