Individual
TARA PATRICIA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MSN, FNP-BC
Contact information
Practice address
115 KING LEES CT, LEXINGTON, SC 29072-7089
(803) 239-4660
(803) 233-4656
Mailing address
955 EAST MAIN STREET SUITE E #6 LEXINGTON, SC 29072, LEXINGTON, SC 29072-3440
(803) 239-4660
(803) 233-4656
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024168713
VA
363LF0000X
Family Nurse Practitioner
Primary
27964
SC
363LF0000X
Family Nurse Practitioner
RN274303
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024905300
—
DC
Enumeration date
08/01/2007
Last updated
08/19/2024
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