Individual
LAURA DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1001 JOHNSON FERRY RD, ATLANTA, GA 30342
(404) 785-3826
(404) 785-3850
Mailing address
4635 MOUNTAIN CREEK DR, ROSWELL, GA 30075
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN075009
GA
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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