Individual
MARYANNE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
920 OLIVER RD, MONROE, LA 71201-5702
(318) 807-6263
(318) 812-7348
Mailing address
130 DESIARD ST, SUITE 355, MONROE, LA 71201-7319
(318) 807-7875
(318) 812-6603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP03438
LA
363LW0102X
Women's Health Nurse Practitioner
AP03438
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1439916
—
LA
Enumeration date
03/16/2007
Last updated
06/11/2019
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