Davis, Amanda Nicole

Davis, Amanda Nicole is an individual health care provider with primary practice located at 280 Pattonsville Rd , Jackson OH 45640-9452. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Davis, Amanda Nicole can be contacted via phone (740) 395-8805.

Contact Information

Primary practice address
280 Pattonsville Rd Jackson OH 45640-9452
Phone: (740) 395-8805
Fax: (740) 395-8855
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X COA.12007-NP Ohio

Profile Details

NPI number 1164724787
LBN Legal business name Davis, Amanda Nicole
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2010
Last updated Aug 7th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164724787 NPPES
West Virginia MEDICAID 3810019225
West Virginia Other 000000691801
West Virginia MEDICAID 3108845

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