Provider Demographics
NPI:1588279871
Name:RIDLEY-DAVIS, CABRINA R
Entity type:Individual
Prefix:
First Name:CABRINA
Middle Name:R
Last Name:RIDLEY-DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 WESTBANK EXPY
Mailing Address - Street 2:
Mailing Address - City:WESTWEGO
Mailing Address - State:LA
Mailing Address - Zip Code:70094-4713
Mailing Address - Country:US
Mailing Address - Phone:504-688-2211
Mailing Address - Fax:504-688-2223
Practice Address - Street 1:1070 WESTBANK EXPY
Practice Address - Street 2:
Practice Address - City:WESTWEGO
Practice Address - State:LA
Practice Address - Zip Code:70094-4713
Practice Address - Country:US
Practice Address - Phone:504-688-2211
Practice Address - Fax:504-688-2223
Is Sole Proprietor?:No
Enumeration Date:2020-09-13
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN129230163W00000X
LA216215363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse