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Amy L Davis

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

3009 N Ballas Rd Ste 383c, Saint Louis, MO 63131-2324

PECOS Enrollment

This provider is enrolled in PECOS as AMY DAVIS.

Based on the most recent information from CMS, provider Amy L Davis is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1811412513
Provider Type
Individual
Full Name
Davis, Amy L
Credential
NP

Gender
Female
Sole Proprietor
No
Enumeration Date
8/3/2017
Last Updated
8/14/2023

Contact Information

Practice Location

3009 N Ballas Rd Ste 383c, Saint Louis, MO 63131-2324

(314) 996-7014

Unlisted Fax

Mailing Location

3009 N Ballas Rd Ste 383c, Saint Louis, MO 63131-2324

(314) 996-7014

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 2017023147 Missouri
Code 363LA2200X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 2009015568 Missouri
Code 363LG0600X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 2009015568 Missouri

Amy L Davis

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Huenefeldt, Elizabeth Ann

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Lemp, Shannon E

Emery, Valerie Beckham

Akinsete, Adetoun A

Effland, Lori A

Blase, Louise

Brice, Mary H

Bayne, Ann Marie