Individual
MR. STEVEN ALLEN DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
301 S LAKE ST, FARMINGTON, NM 87401-5619
(505) 278-8575
Mailing address
405 N MOORE ST, BLOOMFIELD, NM 87413-5580
(505) 419-7921
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
60646
NM
Other
Enumeration date
01/16/2020
Last updated
10/07/2020
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