John Davis Valid NPI

Individual provider · Registered Nurse · O Fallon, IL

NPI

1396174751

Type

Individual (Type 1)

Primary specialty

Registered Nurse

Specialty group

Nursing Service Providers

Taxonomy code

163W00000X

License number

041341411 (IL)

Sex

Male

Sole proprietor

No

Enumerated

2013-11-06

Last updated

2013-11-06