Individual provider · Type 1 NPI
Carolyn Yvonne Davis, PNP
Pediatric Registered Nurse · Angola, IN
NPI number
1629617097
Active
Practice location
909B South Darling Street
Angola, IN 46703
Fax (260) 664-2452
Mailing address
PO Box 7, 1305 West Main Street
Pleasant Lake, IN 46779-0007
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | 28047285A (IN) |
| Pediatric Nurse Practitioner | 363LP0200X | AP109792 (TX) |
| Pediatric Nurse Practitioner | 363LP0200X | 71009581A (IN) |
| Pediatric Registered Nurse Primary | 163WP0200X | 575639 (TX) |
Pediatric Registered Nurse: Definition to come...
About NPI 1629617097
Carolyn Yvonne Davis, PNP's National Provider Identifier is 1629617097, issued on Jan 2, 2020. The primary taxonomy on file is Pediatric Registered Nurse (163WP0200X), and the practice location is in Angola, IN. The record was last updated on Jan 2, 2020.