Healthcare Provider Details

I. General information

NPI: 1457403131
Provider Name (Legal Business Name): BARBARA ANNE DAVIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA GORICHS RN

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 E ALLMAN ST
MEDFORD WI
54451
US

IV. Provider business mailing address

602 E ALLMAN ST
MEDFORD WI
54451
US

V. Phone/Fax

Practice location:
  • Phone: 715-748-9391
  • Fax:
Mailing address:
  • Phone: 715-748-9391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR1084070
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberR1084070
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: