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1710687678
JACQUELINE VIOLET DAVIS
FREEPORT, NY
NPI
1710687678
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: NY 582057-1)
Enumeration Date
2023-03-08
Last Update Date
2023-03-08
Business Address
Dr. JACQUELINE VIOLET DAVIS
642 MILLER AVE
FREEPORT, NY 11520-6313
Phone number: 347-610-6206
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Mailing Address
Dr. JACQUELINE VIOLET DAVIS
642 MILLER AVE
FREEPORT, NY 11520-6313
Phone number: 347-610-6206
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