Individual
THEA A DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
2152 S VINEYARD STE 129, MESA, AZ 85210-6882
(480) 443-8400
Mailing address
7544 E IRWIN AVE, MESA, AZ 85209-4130
(480) 443-8400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP11430
AZ
363LG0600X
Gerontology Nurse Practitioner
AP11430
AZ
363LP2300X
Primary Care Nurse Practitioner
AP11430
AZ
Other
Enumeration date
11/13/2018
Last updated
06/13/2023
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