Individual
TANNER DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
8101 CLAYTON RD, CLAYTON, MO 63117-1103
(314) 726-2124
Mailing address
4707 SNOW WHITE TER, ALTON, IL 62002-5829
(618) 980-1210
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2025006202
MO
Other
Enumeration date
03/08/2025
Last updated
03/08/2025
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