MEDICARE: DR. KIMBERLY MICHELLE DAVIS N.D.

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	175F00000X	Naturopath	000238	CT

General Provider Information

NPI Number	:	1942311733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY MICHELLE DAVIS N.D.

Provider Business Mailing Address
First Line	:	250 ROSEDALE AVE
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-5425
Country	:	US
Telephone Number	:	914-997-6960
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 WESTERMAN AVE
Second Line	:
City	:	SEYMOUR
State	:	CT
Zip	:	06483-3320
Country	:	US
Telephone Number	:	203-888-8616
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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