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Individual

MRS. ANDREA LYNN DAVENPORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, FNP-BC

Contact information

Practice address
703 W PARK ST, CAYUGA, IN 47928-8207
(765) 492-9042
Mailing address
4264 S 430 E, KINGMAN, IN 47952-8037
(765) 376-2320

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71009111A
IN

Other

Enumeration date
07/11/2019
Last updated
07/11/2019
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