Doctor Name: | MS. ANN DAVIS |
NPI Number: | 1043253818 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ANP |
License Number: | 074640 |
Business Practice Address: | 1225 Graham Rd Ste 2310c Florissant, MO - 630318012 |
Business Phone Number: | 3149536300 |
Business Fax Number: | 3149536309 |
Mailing Address: | 670 Mason Ridge Center Dr, Suite 300 SAINT LOUIS |
State: | MO |
Postal Code: | 631418573 |
Phone Number: | 3149536300 |
Fax Number: | 3149536309 |
NPI Enumeration Date: | 06/13/2006 |
NPI Last Update Date: | 12/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 074640 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |