| NPI | 1649700287 |
|---|---|
| Former Name | CARLY ANNE DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 020538) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 020538) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2021-06-01 |