Individual
TARA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
2245 N STATE ST, CLARKSDALE, MS 38614-6102
(662) 627-4131
(662) 627-2702
Mailing address
PO BOX 1447, CLARKSDALE, MS 38614-1447
(662) 627-4131
(662) 627-2702
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902705
MS
Other
Enumeration date
06/26/2018
Last updated
06/26/2018
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