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General NPI Number Information
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NPI Number | 1396163820
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Entity Type | Organization
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Legal Business Name | PRECISION FAMILY HEALTHCARE, LLC
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Dates
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Enumeration Date | 04/02/2014
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Last Update Date | 09/01/2020
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Provider Practice Location Address
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Address Line | 24 GLENDALE AVE
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City | BAXLEY
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State | GA
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Zip | 31513-0244
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Country | US
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Telephone | 912-614-6780
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Fax |
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Provider Business Mailing Address
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Address Line | 24 GLENDALE AVE
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City | BAXLEY
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State | GA
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Zip | 31513-0244
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Country | US
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Telephone | 912-614-6780
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KIMBERLY FAULK DAVIS
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Credential | FNP
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Telephone | 912-614-6780
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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 | RN120009
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License Number State | GA
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