Mrs Connie M Davis, CPNP is a
Nurse Practitioner - Pediatrics based in Clatskanie, Oregon. Mrs Connie M Davis is licensed to practice in Oregon (license number 32996) and her current practice location is
401 Sw Bel Air Drive, Clatskanie, Oregon. She can be reached at her office (for appointments etc.) via phone at
(503) 728-0424.
NPI number for Mrs Connie M Davis is 1538142864 and her current mailing address is Po Box 927, Clatskanie, Oregon. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1538142864.
Provider's Profile
| Full Name | Mrs Connie M Davis |
|---|
| Gender | Female |
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| Speciality | Nurse Practitioner - Pediatrics |
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| Location | 401 Sw Bel Air Drive, Clatskanie, Oregon |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1538142864
- Provider Enumeration Date: 11/21/2005
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mrs Connie M Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538142864 | NPI | - | NPPES |
| 0201816 | Other | WA | WASHINGTON L & I |
| 277983 | Medicaid | OR | |
| L3054-02 | Other | OR | PACIFIC SOURCE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LP0200X | Nurse Practitioner - Pediatrics | 32996 (Oregon) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Connie M Davis is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Connie M Davis, CPNP
Po Box 927,
Clatskanie, OR 97016-0927
Ph: (503) 728-0424 | Mrs Connie M Davis, CPNP
401 Sw Bel Air Drive,
Clatskanie, OR 97016
Ph: (503) 728-0424 |
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