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NPI Code Detail

MEDICARE: ERIKAH BOHANAN DAVIS PMHNP

MEDICARE: ERIKAH BOHANAN DAVIS PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner5016270NC
2163WC0200XCritical Care Medicine Registered NurseNQLZ3AZ0NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NQLZ3AZ0OTHERNCNC BOARD OF NURSING

General Provider Information

NPI Number : 1205593605
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIKAH BOHANAN DAVIS PMHNP
Provider Business Mailing Address
First Line : 211 CHESTNUT OAKS DR
Second Line :
City : BESSEMER CITY
State : NC
Zip : 28016-9516
Country : US
Telephone Number : 704-616-4560
Fax Number :
Provider Business Practice Location Address
First Line : 101 CABARRUS AVE E STE 200
Second Line :
City : CONCORD
State : NC
Zip : 28025-3781
Country : US
Telephone Number : 855-743-2247
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2021
Last Update Date : 01/17/2026

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