Individual
LISA SUSAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA, APRN
Contact information
Practice address
35 MILES ST, DAMARISCOTTA, ME 04543-4047
(207) 563-1234
(603) 228-2113
Mailing address
23 MOUNTAINSIDE DR, NEWBURY, NH 03255-5205
(603) 727-6253
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
06244323
NH
367500000X
Certified Registered Nurse Anesthetist
RN529981L
PA
367500000X
Certified Registered Nurse Anesthetist
RNA173018
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3096163
—
NH
Enumeration date
06/10/2010
Last updated
01/15/2021
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