Davis, Mona M

Davis, Mona M is an individual health care provider with primary practice located at 215 10Th St , Lewiston ID 83501-1912. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Davis, Mona M can be contacted via phone (208) 799-3100.

Contact Information

Primary practice address
215 10Th St Lewiston ID 83501-1912
Phone: (208) 799-3100
Fax: (208) 799-0349
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP347A Idaho

Profile Details

NPI number 1154341196
LBN Legal business name Davis, Mona M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Mar 7th, 2023 - about 2 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 1154341196 NPPES
Washington MEDICAID 9630088

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