Individual
MRS. BEVERLY ANNE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
076159
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689867004
—
IA
Enumeration date
08/20/2007
Last updated
11/08/2012
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