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Individual

JENNIFER DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPNP-PC

Contact information

Practice address
3815 HARRISON RD, LOGANVILLE, GA 30052-2462
(770) 466-6112
Mailing address
2011 RODEO CT SE, ATLANTA, GA 30316-4917
(276) 492-6373

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN245655
GA

Other

Enumeration date
02/07/2022
Last updated
02/07/2022
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