Paula J Davis

Individual provider Active NPI Licensed Practical Nurse · Chittenango, NY

NPI 1548522246 · NPPES record last updated Jun 9, 2012

Key facts

NPI
1548522246
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
275851 (NY)
Practice address
715 Forbes Ave
Chittenango, NY 13037-1115
Phone
(315) 663-6263
NPI assigned
Jun 9, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
275851NYMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 275851 NY Yes

Addresses

Primary practice location

715 Forbes Ave
Chittenango, NY 13037-1115

Mailing address

715 Forbes Ave
Chittenango, NY 13037-1115
Phone (315) 663-6263

Other providers in Chittenango, NY

All providers in Chittenango, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.