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General NPI Number Information
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NPI Number | 1386118503
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Entity Type | Individual
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Provider Name | CASSANDRA DAVIS NP
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Gender | Female
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Dates
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Enumeration Date | 01/22/2019
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Last Update Date | 01/22/2019
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Provider Practice Location Address
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Address Line | 7940 WILLIAMS POND LN STE 175
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City | CHARLOTTE
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State | NC
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Zip | 28277-8766
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Country | US
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Telephone | 704-752-7779
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Fax |
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Provider Business Mailing Address
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Address Line | 7304 HONEY BEE RD
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City | MONROE
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State | NC
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Zip | 28110-9010
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Country | US
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Telephone | 704-771-2052
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5011382
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License Number State | NC
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