Individual
HEATHER T. DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
121 E MAIN ST, PROVIDENCE, KY 42450-1268
(270) 667-2023
(270) 667-7518
Mailing address
121 E MAIN ST, P.O. BOX 310, PROVIDENCE, KY 42450-1268
(270) 667-2023
(270) 667-7518
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3005719
KY
363LF0000X
Family Nurse Practitioner
Primary
3005719
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
KY
Enumeration date
09/04/2008
Last updated
03/07/2023
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