Organization Name: | PRECISION FAMILY HEALTHCARE, LLC |
NPI Number: | 1396163820 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KIMBERLY FAULK DAVIS (OWNER) |
Mailing Address: | 24 Glendale Ave Baxley |
State: | GA US |
Postal Code: | 315130244 |
Phone Number: | 9126146780 |
Fax Number: | |
NPI Enumeration Date: | 04/02/2014 |
NPI Last Update Date: | 04/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN120009 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |