Individual
DEANNA L DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
401 KELLINGS FARM RD, EAST CARONDELET, IL 62240-1241
(678) 517-4802
Mailing address
401 KELLINGS FARM RD, EAST CARONDELET, IL 62240-1241
(678) 517-4802
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN127022
GA
Other
Enumeration date
12/04/2006
Last updated
11/15/2025
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