Individual
AMANDA RAE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
8401 MARKET ST, BOARDMAN, OH 44512
(330) 729-4298
(330) 729-1897
Mailing address
8401 MARKET ST, BOARDMAN, OH 44512-6725
(330) 729-4298
(330) 729-1897
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
COA-15217
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0114514
—
OH
Enumeration date
01/13/2014
Last updated
06/14/2018
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