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Individual

KARA DAVIS FAITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 706-5911
(541) 706-2645
Mailing address
4141 5TH ST, RAPID CITY, SD 57701-6021
(605) 341-2424
(605) 341-4547

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
615
MT
363AS0400X
Surgical Physician Assistant
Primary
0758
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6834860
SD
Enumeration date
07/29/2010
Last updated
05/09/2022
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