Individual
MRS. LEESA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 609-6440
(910) 609-5365
Mailing address
PO BOX 40908, FAYETTEVILLE, NC 28309-0908
(910) 609-6440
(910) 609-5365
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
142777
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
2870
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8057549
—
NC
01
—
D3602
MEDCOST
NC
Enumeration date
07/20/2005
Last updated
07/02/2025
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