Provider Demographics
NPI:1558020172
Name:FRANCIS DAVIS, LAURIE (CRNP)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:FRANCIS DAVIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6290
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-0290
Mailing Address - Country:US
Mailing Address - Phone:410-465-8503
Mailing Address - Fax:
Practice Address - Street 1:10290 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-3670
Practice Address - Country:US
Practice Address - Phone:410-465-8503
Practice Address - Fax:410-465-8570
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-10
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPENDING363LF0000X
MDR188535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily