| Doctor Name: | HEATHER NICOLE DAVIS |
| NPI Number: | 1013237163 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 724111 |
| Business Practice Address: | 605 Ne 9th St Smithville, TX - 789571025 |
| Business Phone Number: | 5123605272 |
| Business Fax Number: | 5123603060 |
| Mailing Address: | 4616 W Howard Ln, L AUSTIN |
| State: | TX |
| Postal Code: | 787286300 |
| Phone Number: | 5123248960 |
| Fax Number: | |
| NPI Enumeration Date: | 06/10/2010 |
| NPI Last Update Date: | 10/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 724111 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |