NPI | 1831636281 |
---|---|
Former Name | LEONA M DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 282N00000X General Acute Care Hospital |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2016037517) |
363LF0000X Nurse Practitioner, Family (Licence: MO 2019007962) | |
Enumeration Date | 2017-01-24 |
Last Update Date | 2024-09-10 |