NPI 1215572409

Carla L Davis

Practitioner Preferred Provider Organization Milwaukee, WI

Practice location

Address: 3709 N. 41st Street, Milwaukee, WI 53216-3044
Phone: (414) 499-7270
Mailing address: 3709 N 41st St, Milwaukee, WI 53216-3044

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X

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Registry record

NPI: 1215572409
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 Nov 2019
Record last updated: 12 Nov 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.