Individual
KORTNI MICHELLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
96 JONATHAN LUCAS ST, CHARLESTON, SC 29425-8900
(843) 792-1414
Mailing address
6607 BUTTERCUP DR, CHEYENNE, WY 82009-5718
(307) 286-6894
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/14/2024
Last updated
02/20/2026
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