Individual
NAALA LATRICE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
415 HIGHWAY 61, SHAW, MS 38773-9425
(662) 754-2226
Mailing address
PO BOX 992, GREENWOOD, MS 38935-0992
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
27827
TN
363LF0000X
Family Nurse Practitioner
Primary
904015
MS
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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