Healthcare Provider Details

I. General information

NPI: 1831507078
Provider Name (Legal Business Name): REBECCA DAVIS DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8044 SUMMA AVE BLDG 1A
BATON ROUGE LA
70809-3411
US

IV. Provider business mailing address

8044 SUMMA AVE BLDG 1A
BATON ROUGE LA
70809-3411
US

V. Phone/Fax

Practice location:
  • Phone: 225-218-4816
  • Fax: 225-302-5057
Mailing address:
  • Phone: 225-218-4816
  • Fax: 225-302-5057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP07837
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: