Healthcare Provider Details

I. General information

NPI: 1346474012
Provider Name (Legal Business Name): MELODY L DAVIS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 04/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 N WATER ST 10TH FLOOR
MOBILE AL
36602-3809
US

IV. Provider business mailing address

333 COMMERCE ST SUITE 700
NASHVILLE TN
37201-1826
US

V. Phone/Fax

Practice location:
  • Phone: 362-341-2870
  • Fax: 362-341-2870
Mailing address:
  • Phone: 615-913-5086
  • Fax: 888-494-2588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1089234
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: