Individual
MRS. ANGELA C DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1100 ANDRE ST STE 300, YPS - CREDENTIALING, NEW IBERIA, LA 70563-2159
(337) 364-9225
(337) 364-6094
Mailing address
1114 PINE ST, MADISONVILLE, LA 70447-9705
(985) 707-3218
(614) 442-2410
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP06028
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790017523
BCBS LA
LA
05
—
2135619
—
LA
Enumeration date
02/04/2010
Last updated
12/07/2016
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