MEDICARE: MEREDITH DAVIS

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	363LF0000X	Family Nurse Practitioner	APN.0995719-NP	CO

General Provider Information

NPI Number	:	1538779699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEREDITH DAVIS

Provider Business Mailing Address
First Line	:	7392 S EVERETT CT
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80128-4139
Country	:	US
Telephone Number	:	303-335-6114
Fax Number	:

Provider Business Practice Location Address
First Line	:	2454 HWY 6 AND 50 STE 104
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1117
Country	:	US
Telephone Number	:	970-644-9900
Fax Number	:

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

Provider Enumeration Date	:	08/04/2020
Last Update Date	:	10/20/2020

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Directions to “ MEREDITH DAVIS ” Practice Location

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