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NPI Code Detail

MEDICARE: ALEXANDRIA DAVIS

MEDICARE: ALEXANDRIA 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
1367500000XCertified Registered Nurse Anesthetist894944TX

General Provider Information

NPI Number : 1629815105
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRIA DAVIS
Provider Business Mailing Address
First Line : 4807 SAN REMO DR
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-8643
Country : US
Telephone Number : 817-401-8602
Fax Number :
Provider Business Practice Location Address
First Line : 171 ASHLEY AVE
Second Line :
City : CHARLESTON
State : SC
Zip : 29425-0100
Country : US
Telephone Number : 843-792-1414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2024
Last Update Date : 07/11/2024

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Directions to “ ALEXANDRIA DAVIS ” Practice Location

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