Individual
ANETRA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AANP
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0287
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN147909
LA
363L00000X
Nurse Practitioner
Primary
227422
LA
363LF0000X
Family Nurse Practitioner
227422
LA
Other
Enumeration date
07/08/2022
Last updated
01/06/2023
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