| 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 |