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General NPI Number Information
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NPI Number | 1194404459
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Entity Type | Organization
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Legal Business Name | DAVIS UNLIMITED HEALTHCARE SERVICES, PLLC
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Dates
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Enumeration Date | 07/14/2023
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 1148 OLD HIGHWAY 61 STE 100
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City | CLEVELAND
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State | MS
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Zip | 38732-9735
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Country | US
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Telephone | 662-545-2421
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Fax | 662-200-5908
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Provider Business Mailing Address
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Address Line | 1148 OLD HIGHWAY 61 STE 100
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City | CLEVELAND
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State | MS
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Zip | 38732-9735
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Country | US
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Telephone | 662-545-2421
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Fax | 662-200-5908
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Authorized Official
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Title or Position | CEO
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Name | NORA GOUGH-DAVIS
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Credential | DNP
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Telephone | 662-545-2421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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