# MRS. LORRAINE THERESA DAVIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1710020367
- **Gender:** F
- **Credential:** MS, PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 15-02452 | KS | Yes |
| 363A00000X | Physician Assistant | PT796 | WY | — |
| 363AM0700X | Medical Physician Assistant | PT796 | WY | — |
| 363AS0400X | Surgical Physician Assistant | PT796 | WY | — |

## Other

- **Enumeration date:** 02/14/2007
- **Last updated:** 02/16/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1710020367 | — | CA |
| 05 | — | 1710020367 | — | KS |