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Individual

CRISTALETTE ANN DAVENPORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
9300 DEWITT LOOP, FORT BELVOIR, VA 22060-5285
(571) 231-1402
(571) 231-6641
Mailing address
2014 HORIZON CT APT 202, WOODBRIDGE, VA 22191-3934
(732) 644-5691

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002080913
VA

Other

Enumeration date
07/29/2024
Last updated
07/29/2024
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