Individual
SHEILA SANDUBRAE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.P.N., L.P.C.
Contact information
Practice address
830 UPPER CACHE CREEK DR., JACKSON, WY 83001-1281
(307) 733-5227
Mailing address
PO BOX 1281, JACKSON, WY 83001-1281
(307) 733-5227
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
259
WY
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
101062
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
8459
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000156000
MIS
WY
05
—
110958800
—
WY
01
—
169719
MHN
WY
01
—
303551
BC/BS
WY
01
—
308004
MAGELLAN
WY
05
—
8056871000
—
ID
Enumeration date
07/12/2006
Last updated
10/05/2011
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