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General NPI Number Information
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NPI Number | 1376153734
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Entity Type | Individual
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Provider Name | COURTNEY ELIZABETH DAVIS
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Gender | Female
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Dates
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Enumeration Date | 07/31/2020
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 545 ISLAND FORD RD
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City | MADISONVILLE
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State | KY
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Zip | 42431-8727
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Country | US
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Telephone | 270-821-0692
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Fax |
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Provider Business Mailing Address
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Address Line | 545 ISLAND FORD RD
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City | MADISONVILLE
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State | KY
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Zip | 42431-8727
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Country | US
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Telephone |
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 1-112118
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 023836
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License Number State | KY
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