Individual
DR. LAURIE RENE DAVIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12840T
CA
152W00000X
Optometrist
612
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12257005
CAQH
—
01
—
FK321Z
MEDICARE PTAN
NV
Enumeration date
08/16/2005
Last updated
04/17/2026
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