Individual
JACOREY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1364 CLIFTON RD NE # R, ATLANTA, GA 30322-5145
(404) 712-2000
Mailing address
100 UNIVERSITY PKWY, MACON, GA 31206-5145
(478) 471-2700
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
RN279827
GA
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
RN279827
GA
Other
Enumeration date
01/17/2022
Last updated
05/20/2024
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