Individual
KIARA COURTNEY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1233 STATE RD, PLYMOUTH, MA 02360-5133
(508) 224-7701
Mailing address
67 BRIGHAM ST, NEW BEDFORD, MA 02740-2211
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2307849
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
854994
MEDICAID PENDING
MA
Enumeration date
10/18/2016
Last updated
11/18/2022
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