Most Relevant Information
Provider Data
| NPI Number: | 1003560251 |
| Provider Name: | JENNIFER DAVIS CPNP-PC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0200X |
| Specialty: | Nurse Practitioner |
| License Number: | RN245655 |
Most Important Dates
| Enumeration Date: | 02/07/2022 |
| Last Updated: | 02/07/2022 |
Provider Practice Location
3815 HARRISON RD
LOGANVILLE
GA
300522462
Practice Location Phone/Fax
| Phone: | 7704666112 |
| Fax: |
Provider Mailing Location
2011 RODEO CT SE
ATLANTA
GA
303164917
Provider Mailing Phone/Fax
| Phone: | 2764926373 |
| Fax: |