John Davis Sr.
Registered Nurse in O Fallon, IL. Individual provider (NPI-1).
NPI number1396174751
StatusActive
Last updated in NPPESNov 6, 2013
Details
- NPI
- 1396174751
- Entity type
- Individual (NPI-1)
- Name
- John Davis Sr.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 6, 2013
- Last updated
- Nov 6, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 041341411 | IL | Yes |
| 163W00000X | Registered Nurse | 2004009573 | MO |
Practice location
339 Kings Ridge BlvdO Fallon, IL 62269-6327
Phone 618-624-2969
Mailing address
339 Kings Ridge BlvdO Fallon, IL 62269-6327
Phone 618-624-2969
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 9 Registered Nurse providers in O Fallon · All 1,289 providers in O Fallon
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