Individual
CLINTON DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, PMHNP
Contact information
Practice address
1025 EXECUTIVE PARK BLVD, KINGSPORT, TN 37660-4620
(423) 830-8110
Mailing address
458 HUNTERS CROSSING LN, KINGSPORT, TN 37664-5453
(423) 341-4475
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28302
TN
Other
Enumeration date
09/25/2020
Last updated
09/25/2020
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