IndividualActive
Abby Davis
NPI 1124758479 · Pediatrics Physician · Fruitland, ID
Provider details
- NPI number
- 1124758479
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Sex
- Female
- Sole proprietor
- No
- License
- PA-2612 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1100 Nw 12th St
Fruitland, ID 83619-5040
Phone: (208) 452-6556
Approximate (ZIP-level) locationGet directions
Mailing address
1100 Nw 12th St
Fruitland, ID 83619-5040
Registry dates
- Enumerated
- 2022-06-10
- Last updated
- 2024-01-09
- Certified
- 2024-01-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.