MEDICARE: DR. LASONYA ADELE DAVIS NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	L8-0010634	DE
2	363LW0102X	Women's Health Nurse Practitioner	NPF13746	CA
3	363LW0102X	Women's Health Nurse Practitioner	LH-0010288	DE
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NPF13746	CA

General Provider Information

NPI Number	:	1003814468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LASONYA ADELE DAVIS NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	21 W CLARKE AVE STE 1030
Second Line	:
City	:	MILFORD
State	:	DE
Zip	:	19963-1857
Country	:	US
Telephone Number	:	302-742-9434
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 W CLARKE AVE STE 1030
Second Line	:
City	:	MILFORD
State	:	DE
Zip	:	19963-1857
Country	:	US
Telephone Number	:	302-742-9434
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	10/29/2025

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