Individual
MRS. RAVEN HARGROVE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0287
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
338388
LA
Other
Enumeration date
02/20/2023
Last updated
10/15/2024
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