Mrs Alisa Porter Davis, NP | |
1560 Renaissance Towne Dr Ste 210, Bountiful, UT 84010-7666 | |
(801) 397-6200 | |
(801) 397-6201 |
Full Name | Mrs Alisa Porter Davis |
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Gender | Female |
Speciality | Nurse Practitioner |
Location | 1560 Renaissance Towne Dr Ste 210, Bountiful, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427789064 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 6991383-4405 (Utah) | Primary |
Entity Name | Woundtech Of Utah Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750922415 PECOS PAC ID: 3779919063 Enrollment ID: O20200205000711 |
Entity Name | Ogden Clinic Specialty Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114203668 PECOS PAC ID: 1658781422 Enrollment ID: O20201105001806 |
Mailing Address | Practice Location Address |
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Mrs Alisa Porter Davis, NP Po Box 5546, Denver, CO 80217-5546 Ph: (801) 475-3500 | Mrs Alisa Porter Davis, NP 1560 Renaissance Towne Dr Ste 210, Bountiful, UT 84010-7666 Ph: (801) 397-6200 |
Kenzlee Wooden, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 845 S Main St Ste A7, Bountiful, UT 84010 Phone: 801-298-0903 | |
Daelyn Tasha Clawson, RN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 390 N Main St, Bountiful, UT 84010 Phone: 801-397-6670 | |
Miss Lauren Lightfield, AGACNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 458 N 500 W, Bountiful, UT 84010 Phone: 801-292-9355 Fax: 801-296-8050 | |
Sarah Elizabeth Mcmillin, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 111 W 3100 S, Bountiful, UT 84010 Phone: 801-668-7479 | |
Mistie Sue Manning, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1551 Renaissance Towne Dr Ste 370, Bountiful, UT 84010 Phone: 801-747-7244 | |
Dr. Rachel Starr Wagner Pollard, DNP, APRN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 320 W 500 S Ste 210, Bountiful, UT 84010 Phone: 801-797-9121 | |
Janice M Trump, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 630 Medical Dr, Bountiful, UT 84010 Phone: 801-299-3781 |