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General NPI Number Information
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NPI Number | 1780221390
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Entity Type | Individual
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Provider Name | EMILIE DAVIS MS
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Gender | Female
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Dates
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Enumeration Date | 12/02/2019
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Last Update Date | 12/02/2019
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Provider Practice Location Address
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Address Line | 347 N 300 W STE 203
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City | KAYSVILLE
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State | UT
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Zip | 84037-1828
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Country | US
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Telephone | 801-593-1660
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Fax |
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Provider Business Mailing Address
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Address Line | 163 E DRY CREEK RIDGE LN UNIT B119
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City | SANDY
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State | UT
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Zip | 84070-3936
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Country | US
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Telephone | 801-995-2731
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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