Active NPI
Glenn Davis
- Licensed Vocational Nurse
- Mililani, HI
National Provider Identifier
1770913642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- VN 176642
- Practice address
- 95-270 Waikalani Dr
Apt B104
Mililani, HI 96789-3527 - Phone
- (808) 369-5820
- NPI assigned
- Nov 13, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | VN 176642 | CA | Primary |
Addresses
Primary practice location
95-270 Waikalani Dr
Apt B104
Mililani, HI 96789-3527
Mailing address
95-270 Waikalani Dr
Apt B104
Mililani, HI 96789-3527
Phone (808) 369-5820
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 |
|---|---|---|---|
| VN 176642 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384300800000",
"number": "1770913642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95-270 WAIKALANI DR",
"address_2": "APT B104",
"city": "MILILANI",
"state": "HI",
"postal_code": "967893527",
"telephone_number": "808-369-5820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95-270 WAIKALANI DR",
"address_2": "APT B104",
"city": "MILILANI",
"state": "HI",
"postal_code": "967893527",
"telephone_number": "808-369-5820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "GLENN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-13",
"last_updated": "2013-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "VN 176642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mililani, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.