Individual
LAURA JEAN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
701 S HOLLY AVE, COLLINS, MS 39428-3894
(601) 765-3180
(601) 765-2808
Mailing address
701 S HOLLY AVE, COLLINS, MS 39428-3894
(601) 765-3180
(601) 765-2808
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
902701
MS
Other
Enumeration date
07/10/2018
Last updated
07/10/2018
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