Doctor Name: | MS. KIMBERLY ANN DAVIS |
NPI Number: | 1629341862 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | RN120009 |
Business Practice Address: | 948 S Main St Baxley, GA - 315130138 |
Business Phone Number: | 9123679112 |
Business Fax Number: | 9123676233 |
Mailing Address: | 1111 Glynco Pkwy, Bldg 1 Suite10 BRUNSWICK |
State: | GA |
Postal Code: | 315257921 |
Phone Number: | 9122649111 |
Fax Number: | 9122626909 |
NPI Enumeration Date: | 02/20/2012 |
NPI Last Update Date: | 02/20/2012 |
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: |