Individual
LYEE DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
526 JEFFERSON AVE, WOODBINE, NJ 08270-2109
(800) 950-6066
Mailing address
526 JEFFERSON AVE, WOODBINE, NJ 08270-2109
(800) 950-6066
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NA NJ0608457478
NJ
Other
Enumeration date
09/15/2008
Last updated
09/15/2008
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