Individual
JENNIFER LYNN DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
684 SIXES RD STE 125, HOLLY SPRINGS, GA 30115
(678) 426-5450
Mailing address
416 SHONI LN, WOODSTOCK, GA 30189-5121
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN222665
GA
Other
Enumeration date
01/17/2018
Last updated
07/31/2018
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