Individual
EBONY NICOLE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
169 PARKVIEW RD, SAVANNAH, GA 31419-9671
(912) 677-8231
(888) 494-4209
Mailing address
169 PARKVIEW RD, SAVANNAH, GA 31419-9671
(912) 677-8231
(888) 494-4209
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN076466
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPN076466
LPN STATE LICENSE
GA
Enumeration date
08/19/2019
Last updated
08/19/2019
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