Provider Demographics
NPI:1548347198
Name:DAVIES, REBECCA RAGAN (APRN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:RAGAN
Last Name:DAVIES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:RAGAN
Other - Last Name:SIMMONS & BROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:177 BURT RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2457
Mailing Address - Country:US
Mailing Address - Phone:859-276-1511
Mailing Address - Fax:859-276-3373
Practice Address - Street 1:177 BURT RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2457
Practice Address - Country:US
Practice Address - Phone:859-276-1511
Practice Address - Fax:859-276-3373
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005020363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health