Individual
RANDI DAWNIELLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
1543 COUNTRY CLUB RD, FAIRMONT, WV 26554-1306
(304) 363-2273
Mailing address
1112 PALMER RD, ADAH, PA 15410-1130
(724) 984-9835
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
105753
WV
Other
Enumeration date
10/27/2020
Last updated
04/15/2022
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