MEDICARE: LAURA E DAVIS CNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	13688-NP	OH
2	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	RN.266842	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2012011869	OTHER	OH	ANCC
2	COA.13688-NP	OTHER	OH	CNP
3	RN.266842-COA1	OTHER	OH	REGISTERED NURSE

General Provider Information

NPI Number	:	1437406998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA E DAVIS CNP

Provider Business Mailing Address
First Line	:	5030 TOWNSHIP ROAD 21
Second Line	:
City	:	MARENGO
State	:	OH
Zip	:	43334-9707
Country	:	US
Telephone Number	:	614-499-4076
Fax Number	:

Provider Business Practice Location Address
First Line	:	3454 OAK ALLEY CT STE 209
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-1370
Country	:	US
Telephone Number	:	567-331-2278
Fax Number	:	419-912-5463

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

Provider Enumeration Date	:	08/14/2012
Last Update Date	:	10/12/2025

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