Provider Demographics
NPI:1447522578
Name:DAVIES, CAROLYN ANN (RN)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:ANN
Last Name:DAVIES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14904-1519
Mailing Address - Country:US
Mailing Address - Phone:607-735-3861
Mailing Address - Fax:
Practice Address - Street 1:409 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14904-1519
Practice Address - Country:US
Practice Address - Phone:607-735-3861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY380156163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse