Individual
KATHLEEN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
120 OAKSIDE CT, CANTON, GA 30114-2471
(678) 880-8770
Mailing address
2765 LAWRENCE MILL RUN, MARIETTA, GA 30068-3158
(678) 777-4720
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
RN068065
GA
363LF0000X
Family Nurse Practitioner
Primary
RN068065
GA
Other
Enumeration date
07/07/2015
Last updated
10/21/2020
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