Davis, Renee L

Davis, Renee L is an individual health care provider with primary practice located at 3030 Frank Scott Parkway West Suite 1, Belleville IL 62223-5014. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Davis, Renee L can be contacted via phone (618) 257-2550.

Contact Information

Primary practice address
3030 Frank Scott Parkway West Suite 1 Belleville IL 62223-5014
Phone: (618) 257-2550
Fax: (618) 257-2569
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 036090116 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 209-005885 Illinois

Profile Details

NPI number 1265608251
LBN Legal business name Davis, Renee L
Credentials DNP, APRN, CPNP-PC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 30th, 2008
Last updated Jul 16th, 2024 - about last year

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 1265608251 NPPES
Illinois MEDICAID 209-005885
Illinois MEDICAID 036090116

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