Doctor Name: | KATHLEEN M DAVIS |
NPI Number: | 1093751778 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 140311 |
Business Practice Address: | 401 East Nodaway Oregon, MO - 644739689 |
Business Phone Number: | 6604463307 |
Business Fax Number: | 6604463302 |
Mailing Address: | 401 East Nodaway, OREGON |
State: | MO |
Postal Code: | 644739689 |
Phone Number: | 6604463307 |
Fax Number: | 6604463302 |
NPI Enumeration Date: | 06/21/2006 |
NPI Last Update Date: | 06/19/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 140311 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |