Individual
EMILY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
411 S CENTRAL AVE, IDABEL, OK 74745-6059
(580) 286-7876
(580) 286-5721
Mailing address
107 S HIGH ST, ANTLERS, OK 74523-3818
(580) 298-2830
(580) 298-6723
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0067095
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100744370
—
OK
Enumeration date
03/31/2017
Last updated
03/31/2017
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