Individual
SARAH J DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2 MEMORIAL DR STE 220, ALTON, IL 62002-6723
(618) 474-1723
Mailing address
2 MEMORIAL DR STE 220, ALTON, IL 62002-6723
(618) 474-1723
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209016701
IL
363LA2200X
Adult Health Nurse Practitioner
209016701
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
900068033-62269-01
—
IL
Enumeration date
06/18/2019
Last updated
12/05/2022
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