MEDICARE: MONIKA AURELIA DAVIES CRNA

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
1	163W00000X	Registered Nurse	041-295065	IL
2	367500000X	Certified Registered Nurse Anesthetist	RN2338967	MA
3	367500000X	Certified Registered Nurse Anesthetist	APN.0990451-CRNA	CO

General Provider Information

NPI Number	:	1386603967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIKA AURELIA DAVIES CRNA

Provider Business Mailing Address
First Line	:	511 HILLTOP RD
Second Line	:
City	:	LANCASTER
State	:	MA
Zip	:	01523-2135
Country	:	US
Telephone Number	:	309-360-3329
Fax Number	:

Provider Business Practice Location Address
First Line	:	151 MAIN ST
Second Line	:
City	:	SHREWSBURY
State	:	MA
Zip	:	01545-2101
Country	:	US
Telephone Number	:	844-258-4272
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	11/06/2023

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