Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | NJ00190000 | NJ |
N | 363L00000X | Nurse Practitioner | UP005988U | PA |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 26NJ00190000 | NJ |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | UP005988U | PA |
NPI | 1568545598 |
---|---|
Provider Name | Erin Lynn Davis |
First Address | Philadelphia, PA 19104-4306 |
Second Address | Philadelphia, PA 19104-4306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 17/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P17377 | (02) | PA |