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Individual

THERESA LYNN DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-CNP

Contact information

Practice address
300 W 10TH AVE FL 11, COLUMBUS, OH 43210-1280
(614) 293-6724
(614) 293-6710
Mailing address
700 ACKERMAN RD STE 570, COLUMBUS, OH 43202-1579
(614) 293-6714
(614) 293-6710

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN.CNP.023572
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0326899
OH
Enumeration date
10/24/2018
Last updated
01/10/2019
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