Provider Demographics
NPI:1740440502
Name:DAVEY-RANASINGHE, NICOLE LEE (MD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:LEE
Last Name:DAVEY-RANASINGHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:LEE
Other - Last Name:DAVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1215 S COULTER ST STE 400
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1769
Mailing Address - Country:US
Mailing Address - Phone:806-350-7355
Mailing Address - Fax:806-356-0045
Practice Address - Street 1:1301 S COULTER ST STE 200
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1765
Practice Address - Country:US
Practice Address - Phone:806-350-7655
Practice Address - Fax:806-356-0045
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14088207R00000X
CODR.0053755207R00000X
ORMD158282390200000X
TXR5108207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX376983801Medicaid
COP01416906OtherMEDICARE RAILROAD
NV1184601239Medicaid
CO60777362Medicaid
CO60777362Medicaid