Individual
MS. SUSAN LESLIE DAVIS
Active
Individual
MS. SUSAN LESLIE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHP
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
08-983-P
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174400000X
SPECIALIST
AK
Enumeration date
10/28/2008
Last updated
04/03/2019
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