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General NPI Number Information
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NPI Number | 1255930152
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Entity Type | Individual
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Provider Name | DAVRIN DAVIS RN
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Gender | Male
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Dates
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Enumeration Date | 10/21/2020
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Last Update Date | 12/23/2020
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Provider Practice Location Address
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Address Line | 6900 N DURANGO DR
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City | LAS VEGAS
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State | NV
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Zip | 89149-4409
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Country | US
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Telephone | 702-835-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 630 WILLARD AVE
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City | POCATELLO
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State | ID
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Zip | 83201-3743
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Country | US
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Telephone | 702-469-6284
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN90241
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 837030
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License Number State | NV
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