Healthcare Provider Details

I. General information

NPI: 1437704863
Provider Name (Legal Business Name): KARA ANNE DAVIS CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2019
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11525 HAYNES BRIDGE RD STE 200
ALPHARETTA GA
30009-4822
US

IV. Provider business mailing address

4600 ROSWELL RD BLDG I337
SANDY SPRINGS GA
30342-3125
US

V. Phone/Fax

Practice location:
  • Phone: 770-751-0800
  • Fax:
Mailing address:
  • Phone: 719-761-3195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAC002754
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number272363
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: