Davis, Jeremy P

Davis, Jeremy P is an individual health care provider with primary practice located at 3217 Mabel St , Shreveport LA 71103-4022. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as his primary health care specialty. Davis, Jeremy P can be contacted via phone (318) 631-9121.

Contact Information

Primary practice address
3217 Mabel St Shreveport LA 71103-4022
Phone: (318) 631-9121
Fax: (318) 631-9126
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X AP07028 Louisiana

Profile Details

NPI number 1386997351
LBN Legal business name Davis, Jeremy P
Credentials ACNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2012
Last updated Aug 11th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386997351 NPPES
Louisiana Other AP07028 STATE LICENSE
Louisiana MEDICAID 2318969 STATE LICENSE

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