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NPI Code Detail

MEDICARE: VONA FAYE DAVIS PMHNP

MEDICARE: VONA FAYE DAVIS PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerPMHNPOR
2363LP0808XPsychiatric/Mental Health Nurse PractitionerRN281030MA

General Provider Information

NPI Number : 1922059781
Entity Type Code : Individual
Provider Name (Legal Business Name) : VONA FAYE DAVIS PMHNP
Provider Business Mailing Address
First Line : 115 MILL ST
Second Line :
City : BELMONT
State : MA
Zip : 02478-1048
Country : US
Telephone Number : 617-855-3214
Fax Number :
Provider Business Practice Location Address
First Line : 115 MILL ST
Second Line :
City : BELMONT
State : MA
Zip : 02478-1048
Country : US
Telephone Number : 617-855-3214
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 10/08/2020

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