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General NPI Number Information
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NPI Number | 1326453689
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Entity Type | Organization
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Legal Business Name | REBECCA A DAVIS FNP-C LLC
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Dates
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Enumeration Date | 06/25/2014
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Last Update Date | 06/25/2014
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Provider Practice Location Address
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Address Line | 12902 PLANK RD
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City | BAKER
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State | LA
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Zip | 70714-4911
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Country | US
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Telephone | 225-347-9298
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Fax |
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Provider Business Mailing Address
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Address Line | 26555 ACADIA CT
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-6151
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Country | US
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Telephone | 225-347-9298
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA A DAVIS
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Credential | FNP-C
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Telephone | 225-347-9298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP07837
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License Number State | LA
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