Individual
JOSHUA LUKE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
4100 LAKE DR SE STE 205, GRAND RAPIDS, MI 49546-8292
(616) 267-7414
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1057758
TX
363LA2100X
Acute Care Nurse Practitioner
1057758
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
4704386118
MI
Other
Enumeration date
10/13/2021
Last updated
04/03/2023
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