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NPI 1063775302

NPI 1063775302 : JOANNA LYNN DAVIS CPM, CLS : MARYSVILLE, CA

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General NPI Number Information
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    NPI Number           |    1063775302
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    Entity Type          |    Individual 
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    Provider Name        |    JOANNA LYNN DAVIS CPM, CLS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/21/2012
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    Last Update Date     |    03/31/2025
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Provider Practice Location Address
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    Address Line         |    1930 N BEALE RD 
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    City                 |    MARYSVILLE
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    State                |    CA
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    Zip                  |    95901-6915
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    Country              |    US
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    Telephone            |    469-669-8059
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1930 N BEALE RD 
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    City                 |    MARYSVILLE
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    State                |    CA
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    Zip                  |    95901-6915
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    Country              |    US
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    Telephone            |    469-669-8059
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    174N00000X
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    Taxonomy Name        |    Lactation Consultant (Non-RN)
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    374J00000X
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    Taxonomy Name        |    Doula
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    176B00000X
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    Taxonomy Name        |    Midwife
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    License Number       |    
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    License Number State |    
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