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OLIVIA K DAVIS
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1194232439
Individual Registrant: OLIVIA K DAVIS
Gender: F
Not Sole Proprietor
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
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
Tel: 870-347-2534 Fax: 870-347-2023
Registration Information:
NPI: 1194232439
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | AR | A005450 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
