Ayantae Davis, LPN
Individual provider Active NPI Licensed Practical Nurse · Lumber Bridge, NC
NPI 1982045274 · NPPES record last updated Jul 15, 2013
Key facts
- NPI
- 1982045274
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 76558 (NC)
- Practice address
- 205 Brooke Run
Lumber Bridge, NC 28357-8780 - Phone
- (910) 364-8160
- NPI assigned
- Jul 15, 2013
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 76558 | NC | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 76558 | NC | Yes |
Addresses
Primary practice location
205 Brooke Run
Lumber Bridge, NC 28357-8780
Mailing address
205 Brooke Run
Lumber Bridge, NC 28357-8780
Phone (910) 364-8160
Other providers in Lumber Bridge, NC
- Aandd Carezone Afl LLC
- Leila Brooks
- Carolina Solution Cares
- Childrens Treatment Center Inc
- Lindsey Patricia Delong
- Ashley Franey
- Susan Richey Gaylord
- Christina Marie Johnston
- Katie Lynette Laroche
All providers in Lumber Bridge, NC · Licensed Practical Nurse in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.