Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | A005176 | AR |
NPI | 1013447846 |
---|---|
Provider Name | Paige Lauren Davis |
First Address | Springdale, AR 72762-8454 |
Second Address | Fayetteville, AR 72703-4424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2017 |
Last Update Date | 14/06/2017 |