NPI 1962738872 · live from the CMS NPI Registry
Marnie Davis, PA-C
Physician Assistant in Park Rapids, MN. National Provider Identifier 1962738872, active.
NPI record
| NPI | 1962738872 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 705 Pleasant Ave S, Park Rapids, MN 56470 |
| Practice phone | 218-732-2800 |
| Mailing address | Po Box 6001, Fargo, ND 58108 |
| Enumerated | October 27, 2009 |
| Last updated | November 18, 2014 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Surgical | 363AS0400X | 2914 (CO) |
| Physician Assistant primary | 363A00000X | 10824 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.