Individual
VICTOR DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
625 SNELLING AVE N STE A, SAINT PAUL, MN 55104-5585
(651) 363-3111
Mailing address
625 SNELLING AVE N STE A, SAINT PAUL, MN 55104-5585
(651) 363-3111
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
CNP 4761
MN
363LF0000X
Family Nurse Practitioner
Primary
4761
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
4761
MN
Other
Enumeration date
08/20/2015
Last updated
09/27/2021
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