Healthcare Provider Details

I. General information

NPI: 1821646019
Provider Name (Legal Business Name): LINDSEY CIERA DAVIS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY CIERA GOFF RN

II. Dates (important events)

Enumeration Date: 08/30/2019
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KENTON DR
CHARLESTON WV
25311-1256
US

IV. Provider business mailing address

4764 STEELE RIDGE RD
RED HOUSE WV
25168-7700
US

V. Phone/Fax

Practice location:
  • Phone: 304-513-3495
  • Fax:
Mailing address:
  • Phone: 304-206-6760
  • Fax: 304-876-7113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number93385
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number104640
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number104640
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: