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1699388496
KELLY DAVIS
FORT WAYNE, IN
NPI
1699388496
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IN 71010315A)
Enumeration Date
2020-08-31
Last Update Date
2020-08-31
Business Address
KELLY DAVIS FNP
6326 CONSTITUTION DR
FORT WAYNE, IN 46804-1518
Phone number: 260-969-6200
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Mailing Address
KELLY DAVIS FNP
4107 ROCKY KNOLL CT
FORT WAYNE, IN 46809-9534
Phone number: 260-466-8908
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