Provider Demographics
NPI:1033416896
Name:DAVIS, EMILY MOWRY (NP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MOWRY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5307 TOLER ST
Mailing Address - Street 2:
Mailing Address - City:HARAHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70123-5220
Mailing Address - Country:US
Mailing Address - Phone:504-570-1471
Mailing Address - Fax:504-570-1472
Practice Address - Street 1:5307 TOLER ST
Practice Address - Street 2:
Practice Address - City:HARAHAN
Practice Address - State:LA
Practice Address - Zip Code:70123-5220
Practice Address - Country:US
Practice Address - Phone:504-570-1471
Practice Address - Fax:504-570-1472
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA021405363LF0000X
VA0024168969363LF0000X
LAAP06357363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily