Individual
CHARLENE IVA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
CORNER OF ROUTES N12 & N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
(928) 729-8822
Mailing address
CORNER OF ROUTES N12 & N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
(928) 729-8822
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
RN164808
AZ
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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