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Contact Information

CONNIE M DAVIS, CPNP
401 SW BEL AIR DRIVE
CLATSKANIE, OR97016
 Phone: 503-728-0424
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

363LP0200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for CONNIE M DAVIS · (Female)

NPI # 1538142864
Status Active
Credentials CPNP (Certified Pediatric Nurse Practitioner)
Entity Individual
Enumeration date 11/21/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • OR License # 32996
  • OR Medicaid 277983
  • OR Other L3054-02 PACIFIC SOURCE
  • WA Other 0201816 WASHINGTON L & I
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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