Individual
MRS. RENEE L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, CPNP-PC
Contact information
Practice address
3030 FRANK SCOTT PARKWAY WEST, SUITE 1, BELLEVILLE, IL 62223-5014
(618) 257-2550
(618) 257-2569
Mailing address
3030 FRANK SCOTT PARKWAY WEST, SUITE 1, BELLEVILLE, IL 62223-5014
(618) 257-2550
(618) 257-2569
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
036090116
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
209-005885
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036090116
—
IL
05
—
209-005885
—
IL
Enumeration date
04/30/2008
Last updated
07/16/2024
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