Individual
MRS. PATRICIA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
8 LUNAR DR, WOODBRIDGE, CT 06525-2352
(203) 397-5211
(203) 397-1875
Mailing address
8 LUNAR DR, WOODBRIDGE, CT 06525-2352
(203) 397-5211
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R28707
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90023
PNCB
CT
01
—
90023
PEDIATRIC NURSING CERTIFICATION BOARD
MD
01
—
R28707
LICENSE NB
CT
Enumeration date
03/08/2007
Last updated
12/09/2011
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