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Individual

MS. NANCY C. DAVENPORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
616 W RUSSELL PL, SAN ANTONIO, TX 78212-3658
(800) 257-8715
Mailing address
146 AN COUNTY ROAD 2405, MONTALBA, TX 75853-3220
(903) 549-2155
(903) 723-7378

Taxonomy

Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
525853
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8N8569
BLUE CROSS BLUE SHIELD
TX
01
P00200022
RAIL ROAD
TX
Enumeration date
01/25/2007
Last updated
07/08/2007
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