Provider Demographics
NPI:1396298766
Name:DAVILLA'S HEALTH CARE LLC
Entity type:Organization
Organization Name:DAVILLA'S HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:DAVILLA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:504-410-4197
Mailing Address - Street 1:3436 MAGAZINE ST # 155
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-2413
Mailing Address - Country:US
Mailing Address - Phone:504-410-4197
Mailing Address - Fax:504-324-4150
Practice Address - Street 1:1421 GENERAL TAYLOR ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3717
Practice Address - Country:US
Practice Address - Phone:504-899-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05985363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty