Individual
SHONTA DENISE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14460 W 121ST TER, OLATHE, KS 66062-6056
(913) 390-8211
Mailing address
14460 W 121ST TER, OLATHE, KS 66062-6056
(913) 390-8211
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
13102694122
KS
Other
Enumeration date
10/23/2009
Last updated
10/23/2009
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