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NPI Code Detail

MEDICARE: PHYLLIS ANN DAVIS

MEDICARE:   PHYLLIS ANN DAVIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747A0650XAttendant Care Provider

General Provider Information

NPI Number : 1669023008
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHYLLIS ANN DAVIS
Provider Business Mailing Address
First Line : 4829 VALLEY BIRCH DR
Second Line :
City : ARLINGTON
State : TN
Zip : 38002-4478
Country : US
Telephone Number : 901-326-0972
Fax Number :
Provider Business Practice Location Address
First Line : 4829 VALLEY BIRCH DR
Second Line :
City : ARLINGTON
State : TN
Zip : 38002-4478
Country : US
Telephone Number : 901-326-0972
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2019
Last Update Date : 09/26/2019

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Directions to “ PHYLLIS ANN DAVIS ” Practice Location

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