Provider Demographics
NPI:1336484823
Name:DAVIS, CHINA LYNEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHINA
Middle Name:LYNEL
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 CAMERON BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-4076
Mailing Address - Country:US
Mailing Address - Phone:504-715-1908
Mailing Address - Fax:
Practice Address - Street 1:2000 GERTSNER MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8060
Practice Address - Country:US
Practice Address - Phone:504-715-1908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist