Individual
MISS MARCIA ANTONIA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
4704341865
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
4704341865
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704341865
REGISTERED NURSE
MI
Enumeration date
10/18/2022
Last updated
09/15/2025
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