Individual
JUSTIN N DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2610 S ROCKINGCHAIR RD, PARAGOULD, AR 72450-9609
(870) 240-5877
Mailing address
2610 S ROCKINGCHAIR RD, PARAGOULD, AR 72450-9609
(870) 240-5877
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041.420223
IL
367500000X
Certified Registered Nurse Anesthetist
C003044
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206712001
—
AR
Enumeration date
06/09/2014
Last updated
01/03/2017
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