Individual
MS. YVONNE LORELLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER I
Contact information
Practice address
482 BLACK RIVER PKWY, WATERTOWN, NY 13601-2416
(315) 782-1777
(315) 785-8628
Mailing address
482 BLACK RIVER PKWY, WATERTOWN, NY 13601-2416
(315) 782-1777
(315) 785-8628
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
653726-1
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402154
NY
Other
Enumeration date
06/12/2017
Last updated
03/17/2018
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