Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | RN1010471 | DC |
NPI | 1053644062 |
---|---|
Provider Name | Kyleen Erin Davis |
First Address | Washington, DC 20007 |
Second Address | Washington, DC 20007-2113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2009 |
Last Update Date | 09/08/2016 |