Individual
SUSAN L DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
20 WORCESTER CENTER BLVD, WORCESTER, MA 01608-1312
(508) 368-3140
(508) 368-3144
Mailing address
14 MANNING AVE, LEOMINSTER, MA 01453-5768
(978) 847-0110
(978) 665-5959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
166356
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042472266
THREE RIVERS
—
01
—
47953
FALLON COMMUNITY HEALTH
—
01
—
500007983
RAILROAD MEDICARE
—
01
—
AA3609
HARVARD PILGRIM HEALTH
—
01
—
NP1842
BLUE SHIELD INDEMNITY
—
Enumeration date
01/30/2006
Last updated
04/18/2012
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