Individual
MS. RANDI TERRY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
736 IRVING AVE, SYRACUSE, NY 13210-1602
(315) 470-7111
Mailing address
339 CONSORT DR, BALLWIN, MO 63011-4439
(636) 386-9224
(636) 386-7679
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
26NJ00306400
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
306445
NY
367500000X
Certified Registered Nurse Anesthetist
4704197826
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4308712580
BCBS - MICHIGAN
MI
01
—
4308759910
BCBS INDIVIDUAL PIN
MI
05
—
4381587
—
MI
Enumeration date
10/17/2006
Last updated
02/24/2026
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