Individual
JENNIFER DAVISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
843 MILLING AVE, LULING, LA 70070-4442
(504) 575-3712
(504) 575-3691
Mailing address
2900 INDIANA AVE, KENNER, LA 70065-4605
(504) 575-3712
(504) 575-3691
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
09001
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2427113
—
LA
Enumeration date
05/05/2016
Last updated
09/13/2016
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