Individual
KATHLEEN M DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
401 EAST NODAWAY, OREGON, MO 64473-9689
(660) 446-3307
(660) 446-3302
Mailing address
401 EAST NODAWAY, OREGON, MO 64473-9689
(660) 446-3307
(660) 446-3302
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
140311
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427175302
—
MO
Enumeration date
06/21/2006
Last updated
11/10/2021
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