Individual
MARCIA CAMILLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
124 W THOMAS RD, PHOENIX, AZ 85013-4405
(602) 406-4366
(602) 798-9829
Mailing address
904 N CRESTON, MESA, AZ 85213-5426
(480) 656-1065
(480) 656-1067
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP2300
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102124
—
AZ
Enumeration date
08/30/2006
Last updated
07/09/2007
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