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General NPI Number Information
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NPI Number | 1518248699
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Entity Type | Individual
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Provider Name | SHELLY ELIZABETH DAVIS NP
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Gender | Female
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Dates
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Enumeration Date | 09/02/2011
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 200 HYGEIA DR
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City | NEWARK
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State | DE
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Zip | 19713-2049
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Country | US
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Telephone | 302-273-1701
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Fax | 302-273-4497
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Provider Business Mailing Address
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Address Line | 1801 ASHLEY CIR
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City | BOWLING GREEN
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State | KY
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Zip | 42104-3362
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Country | US
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Telephone | 270-793-2165
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1088723
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3007042
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | LG-0012882
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License Number State | DE
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | LG-0012882
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License Number State | DE
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