Provider Demographics
NPI:1184990715
Name:DAVIS, CINDY (RN)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
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 1:180 DARLINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:SC
Mailing Address - Zip Code:29827-4884
Mailing Address - Country:US
Mailing Address - Phone:706-231-3768
Mailing Address - Fax:262-878-9184
Practice Address - Street 1:180 DARLINGTON AVE S
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:SC
Practice Address - Zip Code:29827-4884
Practice Address - Country:US
Practice Address - Phone:706-231-3768
Practice Address - Fax:262-878-9184
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI152182-030163W00000X
SC275745163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse