Individual
JERRY LEE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
110 HIDDEN VALLEY RD, MC MURRAY, PA 15317-2685
(724) 941-4070
Mailing address
110 HIDDEN VALLEY RD, MC MURRAY, PA 15317-2685
(724) 941-4070
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
95031382
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP030985
PA
Other
Enumeration date
10/17/2024
Last updated
10/23/2024
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