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General NPI Number Information
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NPI Number | 1750746202
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Entity Type | Individual
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Provider Name | RACHEL DAVENPORT NP
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Gender | Female
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 403 PRINCETON RD #1
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City | JOHNSON CITY
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State | TN
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Zip | 37601-2056
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Country | US
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Telephone | 423-283-9913
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Fax | 423-283-9908
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Provider Business Mailing Address
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Address Line | 403 PRINCETON RD #1
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City | JOHNSON CITY
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State | TN
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Zip | 37601-2056
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Country | US
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Telephone | 423-283-9913
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Fax | 423-283-9908
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN0000020748
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License Number State | TN
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