Individual
MISS LARIS OLIVIA DAVENPORT
Active
Individual
MISS LARIS OLIVIA DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
710866
PA
367500000X
Certified Registered Nurse Anesthetist
147782
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
NA95002421
CA
Other
Enumeration date
01/26/2021
Last updated
08/27/2024
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