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General NPI Number Information
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NPI Number | 1326041831
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Entity Type | Individual
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Provider Name | WILLIAM G. DAVIS II RN,CS,FNP-C
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Gender | Male
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Dates
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Enumeration Date | 05/30/2005
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Last Update Date | 09/07/2013
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Provider Practice Location Address
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Address Line | 1706 SE WALTON BLVD
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City | BENTONVILLE
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State | AR
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Zip | 72712-3200
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Country | US
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Telephone | 479-464-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 11768 MALLARD DR
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City | NEOSHO
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State | MO
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Zip | 64850-8585
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Country | US
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Telephone | 417-451-0282
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Fax | 417-451-6277
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN089423
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License Number State | MO
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