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General NPI Number Information
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NPI Number | 1023847274
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Entity Type | Individual
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Provider Name | MICHELLE DELANE DAVIS
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Gender | Female
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Dates
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Enumeration Date | 07/27/2024
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 95 YMCA DR STE 1
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City | MADISONVILLE
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State | KY
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Zip | 42431-9035
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Country | US
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Telephone | 270-359-5254
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Fax | 502-546-7016
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Provider Business Mailing Address
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Address Line | PO BOX 994
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City | NORTONVILLE
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State | KY
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Zip | 42442-0994
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Country | US
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Telephone | 270-676-6063
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Fax | 270-676-6064
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4025232
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License Number State | KY
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