Healthcare Provider Details

I. General information

NPI: 1881471340
Provider Name (Legal Business Name): CHELSEA ELAINE DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2023
Last Update Date: 06/11/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 BOULDER CREEK CV
MEMPHIS TN
38134-4456
US

IV. Provider business mailing address

2900 BOULDER CREEK CV
MEMPHIS TN
38134-4456
US

V. Phone/Fax

Practice location:
  • Phone: 205-644-2173
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-177455
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number37604
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: