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OLIVIA K DAVIS

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1194232439

Individual Registrant:
 OLIVIA K DAVIS 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1127 MAIN ST  VILONIA, AR 72173-9525 US
Tel: 501-796-6740  Fax: 501-796-6744

Contact information for business:
PO BOX 497  AUGUSTA, AR 72006-0497 US
Tel: 870-347-2534  Fax: 870-347-2023

Registration Information:
NPI: 1194232439
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
ARA005450

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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