Individual
MR. HENRY EDWARD DAVIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN CNP
Contact information
Practice address
1100 SW 3RD ST, MINCO, OK 73059-3044
(405) 320-9431
(405) 689-3008
Mailing address
1100 SW 3RD ST, MINCO, OK 73059-3044
(405) 381-8380
(405) 689-3008
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
57710
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200811100A
—
OK
Enumeration date
05/11/2018
Last updated
03/10/2025
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