Individual
MS. LAURIE JO DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C, MSN, BSN, RN
Contact information
Practice address
500 S 3RD AVE, BIG RAPIDS, MI 49307-9501
(231) 796-3553
Mailing address
14208 80TH AVE, MECOSTA, MI 49332-9688
(231) 250-5459
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704201573
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
4704201573MOD17848
MI
Other
Enumeration date
05/30/2013
Last updated
12/06/2017
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