Individual
LISA RENEE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1107 BELLEFONTE RD, FLATWOODS, KY 41139-2503
(606) 834-0125
(606) 834-0128
Mailing address
PO BOX 1595, ASHLAND, KY 41105-1595
(606) 408-6200
(606) 408-6612
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3009600
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0160366
—
OH
05
—
3810030198
—
WV
05
—
7100394660
—
KY
Enumeration date
09/30/2015
Last updated
06/17/2016
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