Individual
ADAM TYLER DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
3368 HIGHWAY 280 STE 130, ALEX CITY, AL 35010-3375
(256) 234-2644
(256) 234-2704
Mailing address
3930 MONTCLAIR RD APT E, MOUNTAIN BRK, AL 35213-2424
(334) 398-1534
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-148279
AL
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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