Individual
AMANDA NICOLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
280 PATTONSVILLE RD, JACKSON, OH 45640-9452
(740) 395-8805
(740) 395-8855
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 992-0060
(740) 446-5854
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
COA.12007-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000691801
ANTHEM BCBS
OH
05
—
3108845
—
OH
05
—
3810019225
—
WV
Enumeration date
12/02/2010
Last updated
08/07/2014
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