Provider Demographics
NPI:1538512991
Name:DAVISON, LAURN
Entity Type:Individual
Prefix:MISS
First Name:LAURN
Middle Name:
Last Name:DAVISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8533 E 81ST PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-8000
Mailing Address - Country:US
Mailing Address - Phone:918-407-2294
Mailing Address - Fax:
Practice Address - Street 1:8533 E 81ST PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-8000
Practice Address - Country:US
Practice Address - Phone:918-407-2294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator