Healthcare Provider Details

I. General information

NPI: 1679626824
Provider Name (Legal Business Name): THERESE DAVIS R.N., B.S.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6935 E GOLD DUST AVE
SCOTTSDALE AZ
85253-1447
US

IV. Provider business mailing address

9629 E CORTEZ ST
SCOTTSDALE AZ
85260-6058
US

V. Phone/Fax

Practice location:
  • Phone: 480-484-6500
  • Fax: 480-484-6542
Mailing address:
  • Phone: 480-860-2682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN022937
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: