Active NPI
Holly Faye Davis, L.AC.
- Acupuncturist
- Waconia, MN
National Provider Identifier
1083945604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 1470
- Practice address
- 1322 Eagle Dr
Waconia, MN 55387-1143 - Phone
- (612) 799-3626
- NPI assigned
- Jan 21, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 1470 | MN | Primary |
Addresses
Primary practice location
1322 Eagle Dr
Waconia, MN 55387-1143
Mailing address
1322 Eagle Dr
Waconia, MN 55387-1143
Phone (612) 799-3626
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1470 | MN | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264032000000",
"number": "1083945604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1322 EAGLE DR",
"city": "WACONIA",
"state": "MN",
"postal_code": "553871143",
"telephone_number": "612-799-3626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1322 EAGLE DR",
"city": "WACONIA",
"state": "MN",
"postal_code": "553871143",
"telephone_number": "612-799-3626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "HOLLY",
"middle_name": "FAYE",
"name_prefix": "Mrs.",
"credential": "L.AC.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-21",
"last_updated": "2010-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MN",
"license": "1470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waconia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.