Individual
NINA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1247 E MOCKINGBIRD LN, SANDY, UT 84094-3118
(419) 366-8406
Mailing address
1247 E MOCKINGBIRD LN, SANDY, UT 84094-3118
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
10560013-1302
UT
363LA2200X
Adult Health Nurse Practitioner
816789
NV
Other
Enumeration date
05/29/2019
Last updated
10/16/2020
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