Individual
PHANTASIA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
538 BREWER DR, LOCUST GROVE, GA 30248-2344
(678) 361-3652
Mailing address
538 BREWER DR, LOCUST GROVE, GA 30248-2344
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN269227
GA
Other
Enumeration date
09/17/2021
Last updated
09/17/2021
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