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General NPI Number Information
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NPI Number | 1700696754
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Entity Type | Individual
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Provider Name | ANGELA SUE DAVIS PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/11/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 185 HOSPITAL LN
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4247
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Country | US
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Telephone | 812-841-9688
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Fax | 812-605-5013
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Provider Business Mailing Address
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Address Line | 185 HOSPITAL LN
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4247
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Country | US
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Telephone | 812-243-9954
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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 | 28131991A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 28131991A
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License Number State | IN
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