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Individual
SHANNON REA DAVIS
Active
Individual
SHANNON REA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C , PMHNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
21452
TN
363LF0000X
Family Nurse Practitioner
148870
AK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
148870
AK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
202105062NPPP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
233985
MT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
243410
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP61119130
WA
Other
Enumeration date
10/30/2014
Last updated
03/02/2024
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