Healthcare Provider Details

I. General information

NPI: 1447501341
Provider Name (Legal Business Name): KRISTIN DAVIES MCINTYRE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. KRISTIN DAVIES

II. Dates (important events)

Enumeration Date: 10/02/2012
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31985 LA HIGHWAY 16 STE A
DENHAM SPRINGS LA
70726-1462
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 225-791-8800
  • Fax: 225-791-8889
Mailing address:
  • Phone: 225-791-8800
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.200569
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: