Individual
LATISHA SHUNTISE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
415 N JACKSON ST, AMERICUS, GA 31709-3015
(229) 931-4425
(229) 931-2474
Mailing address
415 N JACKSON ST, AMERICUS, GA 31709-3015
(229) 931-4425
(229) 931-2474
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN062309
GA
Other
Enumeration date
07/29/2011
Last updated
07/29/2011
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