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Individual

MRS. SHANA MONIQUE DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
11 RICHLAND MEDICAL PARK DR, COLUMBIA, SC 29203-6863
(803) 434-4300
(803) 434-4351
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26066
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
5004842
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7004995
NC
Enumeration date
09/21/2010
Last updated
07/20/2023
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