MRS. CONNIE M. DAVIS (NPI# 1538142864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538142864 |
| Entity Type | Individual |
| Full Name | MRS. CONNIE M. DAVIS |
| Credential | CPNP |
| Practice Address |
401 Sw Bel Air Drive Clatskanie OR 97016 |
| Mailing Address |
Po Box 927 Clatskanie OR 97016-0927 |
| Practice Telephone | 5037280424 |
| Mailing Telephone | 5037280424 |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
32996 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | PACIFIC SOURCE | L3054-02 | 01 |
| WA | WASHINGTON L & I | 0201816 | 01 |
| OR | 277983 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494315 | Connie Davis | Family Medicine | 8135 Kenton St, Houston, TX 77028-4631 | 2020-10-16 |
| 1700498326 | Connie Frances Davis | Massage Therapist | 5481 S. Cornell, Chicago, IL 60615 | 2020-08-17 |
| 1457745515 | Connie Davis | Counselor | 9917 Ramshorn St, Thonotosassa, FL 33592-2465 | 2015-03-26 |
| 1619392123 | Connie Lavon Davis | Registered Nurse | 3130 Squalicum Pkwy Ste 100, Bellingham, WA 98225-1940 | 2014-02-20 |
| 1154635803 | Connie Linda Davis | Speech-Language Pathologist | 1610 Shands Dr, Tupelo, MS 38804-1734 | 2010-08-04 |
| 1417078692 | Connie Davis | Nurse Practitioner | 700 Se 5th Ter Ste 2, Crystal River, FL 34429-4865 | 2007-04-03 |
| 1598883902 | Connie Kaye Davis | Counselor | 807 Madison St, Oregon, IL 61061-1735 | 2007-03-26 |
| 1043395841 | Connie L. Davis | Internal Medicine | 208 Hospital Parkway, Mount Vernon, WA 98274 | 2006-10-27 |
| 1821054370 | Connie Marie Davis | Psychologist | 105 Lakeview Road, Mt Gretna, PA 17064 | 2006-04-25 |
| 1831576479 | Connie Rae Davis | Counselor | 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 | 2015-05-04 |
| Street Address |
401 SW BEL AIR DRIVE |
| City | CLATSKANIE |
| State | OR |
| Zip Code | 97016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912373499 | Tiamia Duckett | Counselor | 8715 Sw Center St, Tigard, OR 97016 | 2015-08-19 |
| 1386047231 | Kristen Ann Jepson | Dental Hygienist | 400 S.w. Belair Drive, Clatskanie, OR 97016 | 2014-10-07 |
| 1346535739 | Scott Aaron Smith | Dentist | 400 Sw Bel Air Drive, Clatskanie, OR 97016 | 2011-06-14 |
| 1740504422 | Clatskanie Family Medical Clinic, Inc. | Physician Assistant | 401 Belair Drive, Clatskanie, OR 97016 | 2010-03-24 |
| 1316158215 | Sheila Marie Landis | Chiropractor | 50 Nw 4th St, Clatskanie, OR 97016 | 2007-05-24 |
| 1669696308 | Cecelia W Sanders | Social Worker | 555 Sw Bryant, Clatskanie, OR 97016 | 2007-04-12 |
| 1528116175 | Clatskanie Rural Fire Protection District | Ambulance | 280 Se Third St., Clatskanie, OR 97016 | 2007-01-08 |
| 1578587192 | James H. Tyack Dmd PC | Dentist | 400 Sw Bel Air Dr, Clatskanie, OR 97016 | 2006-07-27 |
| 1699799973 | James Hal Tyack | Dentist | 400 Sw Bel Air Dr., Clatskanie, OR 97016 | 2006-07-27 |
| 1841255197 | Gregory Reed Mann | Dentist | 400 Sw Belair Drive, Clatskanie, OR 97016 | 2006-04-19 |
| Find all providers in zip 97016 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477197705 | Kelsey-jo Audrey Moss | Nurse Practitioner | 704b Ne 62nd Ave, Portland, OR 97213-4351 | 2019-10-30 |
| 1295273399 | Shaudine Woody | Nurse Practitioner | 11790 Sw Barnes Rd Ste 140, Portland, OR 97225-5938 | 2017-02-08 |
| 1457707390 | Sarah Halstead | Nurse Practitioner | 2421 Washburn Way, Klamath Falls, OR 97603-4525 | 2016-05-10 |
| 1164829578 | Debdeep Nath | Nurse Practitioner | 12225 Sw 2nd St Ste 150, Beaverton, OR 97005 | 2014-12-01 |
| 1003239120 | Iva Juric | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd # Cdw6, Portland, OR 97239-3011 | 2014-01-24 |
| 1912339896 | Gabrielle Marie Petersen | Nurse Practitioner | 1713 Penn Ln, Oregon City, OR 97045-1528 | 2013-08-02 |
| 1811249592 | Pollee Hruby Brookings | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd # Cdw7, Portland, OR 97239-3098 | 2012-10-05 |
| 1033470646 | Chelsea Doherty | Nurse Practitioner | 14480 Sw 90th Ave, Portland, OR 97224 | 2012-05-31 |
| 1972814440 | Alicia Marie Mcintire | Nurse Practitioner | 995 Willagillespie Rd # 100, Eugene, OR 97401-2186 | 2010-06-29 |
| 1255662953 | Elizabeth T Millan | Nurse Practitioner | 2150 Ne Daggett Ln, Bend, OR 97701-6560 | 2010-01-19 |
| Find all providers with the same taxonomy | ||||
| City | CLATSKANIE |
| Zip Code | 97016 |
Please comment or provide details below to improve the information on MRS. CONNIE M. DAVIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.