Individual
MS. SHADONNA REANEA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
5744 N 62ND ST, MILWAUKEE, WI 53218-2301
(414) 553-6141
Mailing address
5744 N 62ND ST, MILWAUKEE, WI 53218-2301
(414) 553-6141
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
316338-31
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100033164
—
WI
Enumeration date
09/23/2013
Last updated
11/04/2013
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