Individual
CHARLENE H DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
705 RILEY HOSPITAL DR, RI 1601, INDIANAPOLIS, IN 46202-5109
(317) 944-4842
(317) 948-0126
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
28090894
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71000286
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200277570
—
IN
Enumeration date
09/22/2006
Last updated
01/14/2021
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