Individual
CAROLYN YVONNE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
909B SOUTH DARLING STREET, ANGOLA, IN 46703
(260) 665-3146
(260) 664-2452
Mailing address
PO BOX 7, 1305 WEST MAIN STREET, PLEASANT LAKE, IN 46779-0007
(210) 602-6640
(260) 664-2452
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
28047285A
IN
163WP0200X
Pediatric Registered Nurse
Primary
575639
TX
363LP0200X
Pediatric Nurse Practitioner
71009581A
IN
363LP0200X
Pediatric Nurse Practitioner
AP109792
TX
Other
Enumeration date
01/02/2020
Last updated
01/02/2020
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