Individual
LISA M DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
295 SUMPTER ST, BROOKLYN, NY 11233-2712
(347) 866-5803
Mailing address
295 SUMPTER ST, BROOKLYN, NY 11233-2712
(347) 866-5803
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
415028
NY
Other
Enumeration date
09/26/2019
Last updated
09/26/2019
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