# MARK EDWARD DAVIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1053705871
- **Gender:** Man
- **Credential:** CNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 0024176683 | VA | — |
| 363L00000X | Nurse Practitioner | A155082 | IA | Yes |
| 363L00000X | Nurse Practitioner | C-APN.0000471 | CO | — |
| 363L00000X | Nurse Practitioner | CNP-02625 | NM | — |
| 363L00000X | Nurse Practitioner | F343808-1 | NY | — |

## Other

- **Enumeration date:** 03/19/2015
- **Last updated:** 07/19/2019