Provider Demographics
NPI:1942287610
Name:LEDET, DAVONNA S (RN NP)
Entity type:Individual
Prefix:MS
First Name:DAVONNA
Middle Name:S
Last Name:LEDET
Suffix:
Gender:F
Credentials:RN NP
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Mailing Address - Street 1:51 N DUNLAP ST
Mailing Address - Street 2:SUITE 335
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-4625
Mailing Address - Country:US
Mailing Address - Phone:901-287-5182
Mailing Address - Fax:
Practice Address - Street 1:848 ADAMS AVE
Practice Address - Street 2:NEUROSCIENCE CLINIC - LOBBY LEVEL
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-2816
Practice Address - Country:US
Practice Address - Phone:901-287-5060
Practice Address - Fax:901-287-4540
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2013-10-18
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Provider Licenses
StateLicense IDTaxonomies
TN109329363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3497827Medicaid