Individual
MR. BLAISE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C, FNP-BC
Contact information
Practice address
1910 ROSELAND BLVD, TYLER, TX 75701-4246
(432) 599-0232
(903) 533-0441
Mailing address
1910 ROSELAND BLVD, TYLER, TX 75701-4246
(432) 599-0232
(903) 533-0441
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1069902
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1069902
TX
Other
Enumeration date
02/05/2022
Last updated
04/14/2023
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