Individual
MRS. DIANE M PRIVITOR DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C, PMHNPBC
Contact information
Practice address
1501 STUBBS AVE, MONROE, LA 71201-7120
(318) 816-5116
(318) 855-3429
Mailing address
200 WINTERPARK DR, WEST MONROE, LA 71292-1106
(318) 509-8008
(318) 329-1258
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP05002
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APO5002
LA
Other
Enumeration date
09/26/2006
Last updated
07/07/2021
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