DEBRA MOLLIE DAVIS


Address: 2079 Edgewater Dr, Pekin, IL 61554
Phone: 3093822006

DEBRA MOLLIE DAVIS (NPI# 1376769638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1376769638
Entity Type Individual
Full Name DEBRA MOLLIE DAVIS
Other Name DEBRA MOLLIE WALTERS
Credential RN BSN
Practice Address 2079 Edgewater Dr
Pekin
IL 61554
Mailing Address 587 E Court St
Farmington
IL 61531-1303
Practice Telephone 3093822006
Practice Fax Number 3093822007
Mailing Telephone 3092452862
Enumeration Date 2007-04-17
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WC0400X Registered Nurse
Specialization: Case Management
IL Nursing Service Providers

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Office Location

Street Address 2079 EDGEWATER DR
City PEKIN
State IL
Zip Code 61554

Providers in the same location

NPI Name Taxonomy Address Enumeration
1558838409 Darlene Kay Harrison Registered Nurse 2079 Edgewater Dr, Pekin, IL 61554-7833 2018-10-30
1598244915 Tina I Crawford Registered Nurse 2079 Edgewater Dr, Pekin, IL 61554-7833 2018-08-07
1346524899 Bridgeway Inc Community/Behavioral Health 2079 Edgewater Dr, Pekin, IL 61554 2011-10-03

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1194279000 Shauna L Bivens Nurse Practitioner 3400 Griffin Ave., Pekin, IL 61554 2016-08-09
1720349780 Neal Family Chiropractic PC Chiropractor 2978 Court St., Pekin, IL 61554 2012-06-06
1366750671 Dennis Kammerer Stoller Dentist 1608 Broadway, Pekin, IL 61554 2010-09-21
1013186683 Tazwood Mental Health Center, Inc. Community Based Residential Treatment Facility, Mental Illness 1421 Valle Vista Blvd, Pekin, IL 61554 2008-02-27
1568631133 Tazwood Mental Health Center, Inc. Community Based Residential Treatment Facility, Mental Illness 1425 Valle Vista Blvd, Pekin, IL 61554 2008-02-27
1689856312 Pekin Supportive Living Limited Patnership Assisted Living Facility 1320 Executive Court, Pekin, IL 61554 2007-12-05
1205034824 Winfield Curtis Morgan Dentist 1503 Valle Vista, Pekin, IL 61554 2007-07-05
1649308230 Tazewell County Health Department -dental Health Center Public Health or Welfare 135 Radio City Drive, Suite A & B, North Pekin, IL 61554 2007-03-02
1528118239 Jerry Lee Marshall Dentist 135a-b Radio City Drive, North Pekin, IL 61554 2007-01-12
1144380882 Kevin Conroy Dentist 13 Oh Ave, Pekin, IL 61554 2006-12-11
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Taxonomy Information

Taxonomy Code 163WC0400X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Case Management

Taxonomy Definition

Definition to come...

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Competitor

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City PEKIN
Zip Code 61554

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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