Individual
LANITA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15202 GRAND SUMMIT BLVD APT 201, GRANDVIEW, MO 64030-2790
(816) 352-2081
Mailing address
15202 GRAND SUMMIT BLVD APT 201, GRANDVIEW, MO 64030-2790
(816) 352-2081
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2013038561
MO
Other
Enumeration date
11/11/2022
Last updated
11/11/2022
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