Individual
NATHAN JIM DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1601 GOLF COURSE RD, GRAND RAPIDS, MN 55744-8648
(218) 326-3401
Mailing address
1601 GOLF COURSE RD, GRAND RAPIDS, MN 55744-8648
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R 164799-6
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
083824
MN
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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