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Contact Information

CHARLES S DAVIS, CRNP
19250 N MOBILE ST
CITRONELLE, AL36522-2122
 Phone: 251-866-7454
 Fax: 251-866-9121
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

363LP2300X 50 Nurse Practitioner
 

Pediatrics

363LP0200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for CHARLES S DAVIS · (Male)

NPI Number 1699194522
Status Active
Credentials CRNP (Certified Registered Nurse Practitioner)
Entity Individual
Enumeration date 04/08/2014
Last updated 05/09/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • AL License # 1-091410
  • AL Medicaid 630000013
  • AL Other 011846 MEDICARE GROUP PAYEE NUMBER
  • AL Other 1063439065 NPI GROUP PAYEE NUMBER
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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