Individual
MR. JUSTIN WILLIAM DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-C
Contact information
Practice address
110 W JOHN ROWAN BLVD, BARDSTOWN, KY 40004-2663
(502) 337-7409
Mailing address
2605 SIMPSON CREEK RD, BLOOMFIELD, KY 40008-6110
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3013878
KY
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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