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NPI Code Detail

MEDICARE: MRS. HEATHER R DAVIS RN

MEDICARE:  MRS. HEATHER R DAVIS  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN.315460OH
2163WG0000XGeneral Practice Registered NurseRN.315460OH

General Provider Information

NPI Number : 1225451040
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HEATHER R DAVIS RN
Provider Business Mailing Address
First Line : 7730 STALEY RD
Second Line :
City : NEW CARLISLE
State : OH
Zip : 45344-9751
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7730 STALEY RD
Second Line :
City : NEW CARLISLE
State : OH
Zip : 45344-9751
Country : US
Telephone Number : 937-845-3278
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2014
Last Update Date : 01/30/2014

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Directions to “ MRS. HEATHER R DAVIS RN” Practice Location

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