Individual
JESSICA DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1001 JOHNSON FY RD NE, ATLANTA, GA 30342-1605
(404) 785-5160
Mailing address
914 BRENTWOOD DR SE, SMYRNA, GA 30082-3406
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN224565
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
GA
Enumeration date
04/19/2021
Last updated
04/19/2021
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