MEDICARE: MRS. RENE' L. CROSS-DAVIS ARNP

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
1	363LW0102X	Women's Health Nurse Practitioner	4756P	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11453123	OTHER	KY	CAQH
2	1086330	OTHER	KY	REGISTERED NURSE
3	4756P	OTHER	KY	NURSE PRACTITIONER
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891874434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RENE' L. CROSS-DAVIS ARNP

Provider Business Mailing Address
First Line	:	706 COLUMBIA HWY
Second Line	:
City	:	GREENSBURG
State	:	KY
Zip	:	42743-1118
Country	:	US
Telephone Number	:	270-299-2286
Fax Number	:	270-299-2157

Provider Business Practice Location Address
First Line	:	706 COLUMBIA HWY
Second Line	:
City	:	GREENSBURG
State	:	KY
Zip	:	42743-1118
Country	:	US
Telephone Number	:	270-299-2286
Fax Number	:	270-299-2157

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	11/06/2023

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