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Individual

QUIANA DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2478 NORTH 34TH STREET, MILWAUKEE, WI 53210
(414) 324-8903
Mailing address
2478 NORTH 34TH STREET, MILWAUKEE, WI 53210

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
313850
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1346633112
WI
Enumeration date
03/18/2015
Last updated
06/15/2015
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