Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 5005602 | NC |
NPI | 1083973663 |
---|---|
Provider Name | Haley Rae Davis |
First Address | Centennial, CO 80122-3534 |
Second Address | Littleton, CO 80122-2602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2012 |
Last Update Date | 14/12/2021 |