Individual
MINA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
321 W RINCON ST UNIT 412, CORONA, CA 92878-5710
(951) 532-9913
Mailing address
321 W RINCON ST UNIT 412, CORONA, CA 92878-5710
(951) 532-9913
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
Primary
95191633
CA
363LF0000X
Family Nurse Practitioner
95025097
CA
Other
Enumeration date
07/19/2023
Last updated
08/03/2023
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