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General NPI Number Information
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NPI Number | 1023842424
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Entity Type | Individual
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Provider Name | LILLIAN HELEN DAVIS CRNP
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Gender | Female
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Dates
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Enumeration Date | 08/28/2024
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 800 WHEELING AVE
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City | GLEN DALE
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State | WV
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Zip | 26038-1660
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Country | US
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Telephone | 304-843-3313
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 855
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City | NEW CUMBERLAND
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State | WV
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Zip | 26047-0855
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Country | US
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Telephone | 267-864-6853
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 114433
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP030228
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License Number State | PA
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