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Individual

JANETT DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
3015 VETERANS PKWY S, MOULTRIE, GA 31788-6705
(229) 985-4815
Mailing address
31 W CARRIE CT, BLAKELY, GA 39823-2820
(229) 308-0824

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
RN195675
GA
363LF0000X
Family Nurse Practitioner
Primary
195675
GA

Other

Enumeration date
07/09/2018
Last updated
01/07/2019
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