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Individual
MRS. CORI MICHELLE DAVIS
Active
Individual
MRS. CORI MICHELLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA052373
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1056473
NCCPA CERTIFICATION
—
01
—
MA052373
PA STATE LICENSE
PA
Enumeration date
08/26/2005
Last updated
11/29/2021
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