Individual
JENNA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
110 RUSTIC DR, BRANDON, MS 39047-9025
(601) 941-8321
Mailing address
110 RUSTIC DR, BRANDON, MS 39047-9025
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902730
MS
Other
Enumeration date
01/13/2019
Last updated
01/13/2019
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