Healthcare Provider Details

I. General information

NPI: 1376466706
Provider Name (Legal Business Name): RACHEL WHITNEY DAVIS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 VETERANS PARKWAY N
MOULTRIE GA
31788
US

IV. Provider business mailing address

644 N VETERANS PARKWAY
MOULTRIE GA
31788
US

V. Phone/Fax

Practice location:
  • Phone: 229-668-4501
  • Fax: 229-515-4244
Mailing address:
  • Phone: 229-668-4501
  • Fax: 229-515-4244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP327295
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: