Individual
MACKENZIE FAITH DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
741 PRESIDENT PL STE 210, SMYRNA, TN 37167-6809
(615) 625-7780
Mailing address
P.O. BOX 15004, KNOXVILLE, TN 37901-5004
(865) 541-8895
(865) 633-4808
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
28196
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q061103
—
TN
Enumeration date
09/18/2020
Last updated
05/22/2025
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