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NPI Code Detail

MEDICARE: LAYNE NICOLE DAVIS PHARMD

MEDICARE: LAYNE NICOLE DAVIS PHARMD
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
1183500000XPharmacist24225IA

General Provider Information

NPI Number : 1235807751
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAYNE NICOLE DAVIS PHARMD
Provider Business Mailing Address
First Line : 513 S MAIN ST
Second Line :
City : DANVILLE
State : IA
Zip : 52623-9600
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3140 AGENCY ST
Second Line :
City : BURLINGTON
State : IA
Zip : 52601-1977
Country : US
Telephone Number : 319-752-2773
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2021
Last Update Date : 08/31/2021

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Directions to “ LAYNE NICOLE DAVIS PHARMD” Practice Location

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