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General NPI Number Information
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NPI Number | 1700744042
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Entity Type | Individual
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Provider Name | SHONDRA NICOLE DAVIS
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Gender | Female
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 2005 VETERANS BLVD STE A13
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City | DUBLIN
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State | GA
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Zip | 31021-7504
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Country | US
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Telephone | 478-353-1080
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Fax | 478-353-1260
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Provider Business Mailing Address
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Address Line | 2005 VETERANS BLVD STE A13
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City | DUBLIN
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State | GA
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Zip | 31021-7504
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Country | US
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Telephone | 478-353-1080
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | RN163598
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | RN163598
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN163598
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | RN163598
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License Number State | GA
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