Individual
LAKITA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 W 40TH AVE, PINE BLUFF, AR 71603-6301
(870) 541-7100
Mailing address
1600 W 40TH AVE, PINE BLUFF, AR 71603-6301
(870) 541-7100
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
123832
AR
Other
Enumeration date
04/20/2020
Last updated
04/20/2020
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