Healthcare Provider Details

I. General information

NPI: 1235345588
Provider Name (Legal Business Name): EMILY CHENEY DAVIS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 01/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MEDICAL CENTER BLVD
LAWRENCEVILLE GA
30045-7694
US

IV. Provider business mailing address

7263 GRAND REUNION DR
HOSCHTON GA
30548-4068
US

V. Phone/Fax

Practice location:
  • Phone: 678-442-3317
  • Fax:
Mailing address:
  • Phone: 770-965-6039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: