Individual
AMANDA DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
100 GROSS CRESCENT CIR, FORT OGLETHORPE, GA 30742-3643
(706) 858-2000
Mailing address
2504 MAPLEWOOD DR, CHATTANOOGA, TN 37421-1312
(931) 247-6575
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
24402
TN
Other
Enumeration date
06/26/2018
Last updated
12/31/2018
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