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1992479042
SHAVON DAVIS
GARY, IN
NPI
1992479042
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209023174)
Enumeration Date
2021-08-03
Last Update Date
2023-12-28
Business Address
SHAVON DAVIS NP
1619 W 5TH AVE
GARY, IN 46404-1506
Phone number: 219-886-4788
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Mailing Address
SHAVON DAVIS NP
1619 W 5TH AVE
GARY, IN 46404-1506
Phone number: 773-968-9327
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