Individual
CHRISTINE LYNN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
12203 CORPORATE PKWY, MEQUON, WI 53092-3388
(262) 387-8200
(262) 387-8239
Mailing address
12203 CORPORATE PKWY, MEQUON, WI 53092-3388
(262) 387-8200
(262) 387-8239
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2977-023
WI
363AM0700X
Medical Physician Assistant
2977-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100071900
—
WI
05
—
1679826812
—
WI
Enumeration date
10/25/2012
Last updated
10/18/2023
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