Individual
MARK EDWARD DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
801 5TH ST, SIOUX CITY, IA 51101
(712) 279-2010
(712) 279-2034
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024176683
VA
363L00000X
Nurse Practitioner
Primary
A155082
IA
363L00000X
Nurse Practitioner
C-APN.0000471
CO
363L00000X
Nurse Practitioner
CNP-02625
NM
363L00000X
Nurse Practitioner
F343808-1
NY
Other
Enumeration date
03/19/2015
Last updated
07/19/2019
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