Individual
MISS GLORIA JEAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSE PRACTICAL NU
Contact information
Practice address
4368 N. 52ND STREET, MILWAUKEE, WI 53216
(414) 712-6760
Mailing address
4368 N. 52ND STREET, MILWAUKEE, WI 53216
(414) 712-6760
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
24083-31
WI
Other
Enumeration date
07/13/2010
Last updated
07/13/2010
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