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Individual

CRYSTAL DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
20129 TRACEY ST, DETROIT, MI 48235-1570
(313) 740-8855
Mailing address
20129 TRACEY ST, DETROIT, MI 48235-1570
(313) 740-8855

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704346742
MI
164W00000X
Licensed Practical Nurse
4703108786
MI

Other

Enumeration date
07/17/2014
Last updated
08/25/2020
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