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General NPI Number Information
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NPI Number | 1447740220
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Entity Type | Individual
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Provider Name | CARLY NICOLE DAVIS MS, RDN, LD
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Gender | Female
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Dates
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Enumeration Date | 05/16/2018
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 1077 RACE ST APT 503
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City | DENVER
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State | CO
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Zip | 80206-2830
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Country | US
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Telephone | 501-590-8950
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Fax |
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Provider Business Mailing Address
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Address Line | 414 E CAPITOL AVE APT 313
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City | LITTLE ROCK
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State | AR
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Zip | 72202-2478
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Country | US
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Telephone | 501-590-8950
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2842
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number |
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State | CO
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