Individual
MS. LOUISE L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN BC
Contact information
Practice address
121 MIDDLE STREET, SUITE 404, PORTLAND, ME 04101-4156
(207) 772-8634
Mailing address
121 MIDDLE STREET, SUITE 404, PORTLAND, ME 04101-4156
(207) 772-8634
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
R017880
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006502
ANTHEM BCBS
—
Enumeration date
03/30/2007
Last updated
07/08/2007
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