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General NPI Number Information
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NPI Number | 1285904052
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Entity Type | Individual
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Provider Name | REBECCA CAROLINE DAVIS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 04/26/2021
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Provider Practice Location Address
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Address Line | 1121 JOHNSON FERRY RD STE 320
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City | MARIETTA
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State | GA
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Zip | 30068-5404
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Country | US
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Telephone | 770-509-0017
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Fax | 770-971-7818
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Provider Business Mailing Address
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Address Line | 1455 MONTREAL RD
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City | TUCKER
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State | GA
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Zip | 30084-8100
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN0000016131
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 19060
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN255236
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License Number State | GA
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