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General NPI Number Information
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NPI Number | 1457146292
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Entity Type | Individual
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Provider Name | LASANDRA DAVIS REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 150 YELLOW PINE LN
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City | OCHLOCKNEE
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State | GA
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Zip | 31773-2283
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Country | US
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Telephone | 229-712-5706
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Fax |
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Provider Business Mailing Address
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Address Line | 2042 CHURCH STREET
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City | MEIGS
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State | GA
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Zip | 31765
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Country | US
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Telephone | 229-712-5706
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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 | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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