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Individual

MARY-KATE BOH DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN, FNP-C

Contact information

Practice address
16777 MEDICAL CENTER DR, BATON ROUGE, LA 70816-3254
(225) 754-3278
Mailing address
16777 MEDICAL CENTER DR, BATON ROUGE, LA 70816-3254
(225) 754-3278

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP08666
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02156742
MS
05
2415646
LA
Enumeration date
03/07/2016
Last updated
07/22/2016
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