Provider Demographics
NPI:1497386593
Name:DAVIS, KEEYAN LEA (PHARMD)
Entity Type:Individual
Prefix:
First Name:KEEYAN
Middle Name:LEA
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 1:2700 S BIRCHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-2033
Mailing Address - Country:US
Mailing Address - Phone:504-228-3431
Mailing Address - Fax:
Practice Address - Street 1:1 DREXEL DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-1098
Practice Address - Country:US
Practice Address - Phone:504-520-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.023076183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist