Active NPI
Kwinica Antonette Davidson, RN
- Infusion Therapy Registered Nurse
- Shreveport, LA
National Provider Identifier
1770317067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infusion Therapy Registered Nurse
- License
- 202890
- Practice address
- 6120 Land O Trees St
Shreveport, LA 71119-7404 - Phone
- (318) 560-1702
- NPI assigned
- Aug 28, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infusion Therapy Registered Nurse | 163WI0500X | 202890 | LA | Primary |
Addresses
Primary practice location
6120 Land O Trees St
Shreveport, LA 71119-7404
Mailing address
6120 Land O Trees St
Shreveport, LA 71119-7404
Phone (318) 560-1702
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202890 | LA | MD | Infusion Therapy Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724803200000",
"number": "1770317067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6120 LAND O TREES ST",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711197404",
"telephone_number": "318-560-1702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6120 LAND O TREES ST",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711197404",
"telephone_number": "318-560-1702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "KWINICA",
"middle_name": "ANTONETTE",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-28",
"last_updated": "2024-08-28",
"certification_date": "2024-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "163WI0500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Infusion Therapy",
"state": "LA",
"license": "202890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.