Provider Demographics
NPI:1174111892
Name:DAVIS, DANA MICHELE (APRN, NP-C)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:MICHELE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 HARRIER DR
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-3663
Mailing Address - Country:US
Mailing Address - Phone:678-576-3980
Mailing Address - Fax:
Practice Address - Street 1:149 HARRIER DR
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-3663
Practice Address - Country:US
Practice Address - Phone:678-576-3980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN240050363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily