Individual
DE'JA DANIELLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1517 RIDGEWAY ST, THOMASVILLE, AL 36784-3429
(251) 605-7272
Mailing address
1517 RIDGEWAY ST, THOMASVILLE, AL 36784-3429
(251) 605-7272
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1-164484
AL
363L00000X
Nurse Practitioner
Primary
1-164484
AL
Other
Enumeration date
03/27/2024
Last updated
03/28/2024
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