Individual
SHANNA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 LAURA NELL LN, VALPARAISO, IN 46383-0077
(219) 242-1093
Mailing address
12 LAURA NELL LN, VALPARAISO, IN 46383-0077
(219) 242-1093
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28231940A
IN
Other
Enumeration date
03/04/2021
Last updated
03/04/2021
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