Individual
CRESHA TANARA-TULANI DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
122 PROFESSIONAL DR, WEST MONROE, LA 71291-5332
(318) 807-4611
(318) 807-4615
Mailing address
122 PROFESSIONAL DR, WEST MONROE, LA 71291-5332
(318) 807-4611
(318) 807-4615
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301099354
MI
2084N0400X
Neurology Physician
MD.208218
LA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
4301099354
MI
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
MD208218
LA
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
MD.208218
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134356553
—
LA
Enumeration date
06/11/2009
Last updated
06/17/2024
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