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General NPI Number Information
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NPI Number | 1134668379
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Entity Type | Individual
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Provider Name | RYAN DAVIS DNP
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Gender | Male
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Dates
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Enumeration Date | 02/21/2017
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 1975 TOWN CENTER BLVD
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City | KNOXVILLE
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State | TN
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Zip | 37922-6638
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Country | US
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Telephone | 865-546-3998
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Fax | 865-546-1123
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Provider Business Mailing Address
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Address Line | 900 ELKRIDGE LANDING RD FL 2
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City | LINTHICUM
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State | MD
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Zip | 21090-2924
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Country | US
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Telephone | 443-462-5010
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AC002679
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 22306
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License Number State | TN
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