| NPI | 1467476903 |
|---|---|
| Former Name | LISA JENNIFER DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2005036712) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45809) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2016-06-02 |