| NPI | 1447848643 |
|---|---|
| Former Name | JEANNINE LYNN DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 241762) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN241762) |
| Enumeration Date | 2021-01-04 |
| Last Update Date | 2022-05-22 |