NPI | 1780231910 |
---|---|
Former Name | LAUREN E DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 9550) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 201057) |
363L00000X Nurse Practitioner (Licence: WI 9550-33) | |
Enumeration Date | 2019-08-22 |
Last Update Date | 2019-09-27 |