Individual
MRS. MARY RAE DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2748 CROSSROADS BLVD, GRAND JUNCTION, CO 81506-3933
(970) 255-0900
(970) 255-0901
Mailing address
2748 CROSSROADS BLVD, GRAND JUNCTION, CO 81506-3933
(970) 255-0900
(970) 255-0901
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
75918
CO
Other
Enumeration date
02/09/2007
Last updated
07/08/2007
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