Healthcare Provider Details

I. General information

NPI: 1851604425
Provider Name (Legal Business Name): DEBRA ANNIS DAVIS REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2010
Last Update Date: 07/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 FRANKLIN ST 12TH FLOOR
DENVER CO
80205-5437
US

IV. Provider business mailing address

3506 E 141ST PL
THORNTON CO
80602-8857
US

V. Phone/Fax

Practice location:
  • Phone: 303-861-2121
  • Fax: 303-861-3498
Mailing address:
  • Phone: 303-465-6266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number49219
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: