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Contact Information

SHANNON R DAVIS, NP-C , PMHNP
17051 MERCY DR STE 204
EAGLE RIVER, AK99577-7630
 Phone: 907-696-0096
 Fax: 949-577-4808
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Family

363LF0000X 50 Nurse Practitioner
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for SHANNON R DAVIS · (Female)

NPI Number 1508261702
Status Active
Credentials NP-C , PMHNP
Entity Individual
Enumeration date 10/30/2014
Last updated 03/02/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • AK License # 148870
  • AZ License # 243410
  • MT License # 233985
  • OR License # 202105062NPPP
  • TN License # 21452
  • WA License # AP61119130
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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