Individual
MANDI DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 353-3347
(229) 353-7722
Mailing address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 353-3347
(229) 353-7722
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN150260
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN150260
LICENSE NUMBER
GA
Enumeration date
06/03/2009
Last updated
06/03/2009
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