Individual
SHANNA ANITA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2855 LAWRENCEVILLE SUWANEE RD STE 310-330, SUWANEE, GA 30024-3563
(770) 904-3955
Mailing address
2855 LAWRENCEVILLE SUWANEE RD STE 310-330, SUWANEE, GA 30024-3563
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN067089
GA
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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