Individual
JULIA E DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1 PROFESSIONAL PARK DR, SUITE 21, JOHNSON CITY, TN 37604-6587
(423) 232-6900
(423) 232-6903
Mailing address
1 PROFESSIONAL PARK DR, SUITE 21, JOHNSON CITY, TN 37604-6587
(423) 232-6900
(423) 232-6903
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18666
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063822773
—
VA
05
—
Q005637
—
TN
Enumeration date
05/02/2014
Last updated
02/21/2017
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