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General NPI Number Information
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NPI Number | 1962595744
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Entity Type | Individual
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Provider Name | MICHELLE S DAVIS APRN, NP
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 3900 ST FRANCIS WAY STE 200
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City | LAFAYETTE
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State | IN
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Zip | 47905-4940
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Country | US
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Telephone | 765-775-2800
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Fax | 765-775-2831
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Provider Business Mailing Address
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Address Line | PO BOX 153
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City | CHANNAHON
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State | IL
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Zip | 60410-0153
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Country | US
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Telephone | 630-324-7900
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Fax | 630-324-7946
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 71007546A
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License Number State | IN
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