Individual
GINA C DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
8607 E US HIGHWAY 36 STE 100, AVON, IN 46123-7960
(317) 208-3855
(317) 718-6612
Mailing address
8607 E US HIGHWAY 36 STE 100, AVON, IN 46123-7960
(317) 208-3855
(317) 718-6612
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28114408A
IN
363LA2200X
Adult Health Nurse Practitioner
71000185A
IN
363LF0000X
Family Nurse Practitioner
Primary
71000185A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200504790
—
IN
Enumeration date
08/10/2005
Last updated
02/20/2025
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