Individual
DEREK DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
1107 HAZELTINE BLVD STE 370, CHASKA, MN 55318-1009
(952) 395-1441
(952) 395-1442
Mailing address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10243
MN
Other
Enumeration date
05/15/2023
Last updated
06/02/2023
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