Individual
KENNETH LANCE DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
401 11TH ST NE, SPRINGHILL, LA 71075-4503
(318) 539-1701
(318) 539-5688
Mailing address
401 11TH ST NE, SPRINGHILL, LA 71075-4503
(318) 539-1701
(318) 539-5688
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP10132
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2477765
—
LA
Enumeration date
07/11/2018
Last updated
09/30/2021
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