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General NPI Number Information
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NPI Number | 1902389711
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Entity Type | Individual
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Provider Name | CYNTHIA ANN DAVIS RN
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Gender | Female
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Dates
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Enumeration Date | 09/08/2018
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Last Update Date | 09/08/2018
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Provider Practice Location Address
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Address Line | 1404 CROSS ST
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City | SHILOH
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State | IL
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Zip | 62269-2988
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Country | US
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Telephone | 618-607-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 132 CHATTANOOGA CT
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-3196
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Country | US
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Telephone | 618-334-6308
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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 | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 041409425
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License Number State | IL
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