MEDICARE: LACONDA DAVENPORT FNP

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	363LF0000X	Family Nurse Practitioner	905253	MS
2	363LF0000X	Family Nurse Practitioner	222822	OK
3	363LF0000X	Family Nurse Practitioner	333031	AZ
4	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1629619770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LACONDA DAVENPORT FNP

Provider Business Mailing Address
First Line	:	PO BOX 746093
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6093
Country	:	US
Telephone Number	:	520-475-5418
Fax Number	:	520-300-8034

Provider Business Practice Location Address
First Line	:	2720 S 6TH AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85713-4701
Country	:	US
Telephone Number	:	520-475-5418
Fax Number	:	520-300-8034

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

Provider Enumeration Date	:	09/30/2019
Last Update Date	:	04/03/2026

Similar Medicare Providers

1881645596 — SEAN PAUL ROYAL DORADO PA-C
Practice Location Address:

2720 SOUTH 6TH AVENUE
TUCSON, AZ
85713-4701

Practice Phone: 520-475-5418
Practice Fax: 520-300-8034

1992018980 — ANGELA ARMENTA NP-C
Practice Location Address:

2720 SOUTH 6TH AVE
TUCSON, AZ
85713-4701

Practice Phone: 520-475-5418
Practice Fax: 520-300-8034

1154618650 — DR. MED DAN MD
Practice Location Address:

2720 S 6TH AVE
TUCSON, AZ
85713-4701

Practice Phone: 520-475-5418
Practice Fax: 520-300-8034

1457758609 — ANGELA LEAH OVERTURF FNP-C
Practice Location Address:

2720 SOUTH 6TH AVE
TUCSON, AZ
85713-4701

Practice Phone: 520-475-5418
Practice Fax:

1710600663 — MICHELE ROSELLE LI CAUSI RD, ARNP, FNP-C, CDE
Practice Location Address:

2720 S 6TH AVE
TUCSON, AZ
85713-4701

Practice Phone: 520-475-5418
Practice Fax: 520-300-8034

1023079704 — DR. SHARAD N PANDHI D.D.S.
Practice Location Address:

4701 N 1ST AVE
TUCSON, AZ
85718-5610

Practice Phone: 520-293-2166
Practice Fax:

Directions to “ LACONDA DAVENPORT FNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.