Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 023623 | LA |
NPI | 1124027131 |
---|---|
Provider Name | Dr. Shelley S. Davies |
First Address | Baton Rouge, LA 70817-5128 |
Second Address | Baton Rouge, LA 70817-5128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 27/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1483796 | (05) | LA |
H77553 | (02) | LA |