Healthcare Provider Details

I. General information

NPI: 1710128244
Provider Name (Legal Business Name): ERIN DAVIS GEORGE RN, PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2009
Last Update Date: 03/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE
ATLANTA GA
30308-2208
US

IV. Provider business mailing address

1750 SHILOH RD NW APT 105
KENNESAW GA
30144-6484
US

V. Phone/Fax

Practice location:
  • Phone: 404-727-2966
  • Fax: 404-727-3236
Mailing address:
  • Phone: 770-617-8592
  • Fax: 770-792-3674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberRN152827
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: