Provider Demographics
NPI:1346127065
Name:DAVIS, TIMOTHY MICHAEL (RN)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:MICHAEL
Last Name:DAVIS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4519 HICKORY GROVE DR NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-3596
Mailing Address - Country:US
Mailing Address - Phone:404-384-0160
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2212
Practice Address - Country:US
Practice Address - Phone:404-686-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN334940163WP2201X, 163WW0000X, 163WX0800X, 163WX1500X, 163W00000X, 163WN0800X, 163WM0705X
GAI043820146M00000X
156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate
No156F00000XEye and Vision Services ProvidersTechnician/Technologist
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical