Individual
CAROL A DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
6900 ALDEN DR. BLDG 160, F.E. WARREN AFB, CHEYENNE, WY 82005-4800
(307) 773-5383
Mailing address
5050 POWDERHOUSE RD, CHEYENNE, WY 82009-4800
(307) 634-1311
(307) 634-1271
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
17455.1096
WY
163WC1500X
Community Health Registered Nurse
17455.1096
WY
363L00000X
Nurse Practitioner
17455
WY
363L00000X
Nurse Practitioner
NP-990256
CO
363LF0000X
Family Nurse Practitioner
17455
WY
363LF0000X
Family Nurse Practitioner
Primary
17455.1096
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104101344
—
WY
Enumeration date
10/19/2011
Last updated
05/04/2018
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