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General NPI Number Information
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NPI Number | 1912548322
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Entity Type | Individual
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Provider Name | CASEY DAVIS AGACNP
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Gender | Male
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Dates
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Enumeration Date | 10/07/2019
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Last Update Date | 02/14/2024
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Provider Practice Location Address
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Address Line | 1968 PEACHTREE RD NW
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City | ATLANTA
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State | GA
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Zip | 30309-1281
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Country | US
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Telephone | 404-605-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 105 LESLIE ST SE
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City | ATLANTA
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State | GA
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Zip | 30317-1721
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Country | US
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Telephone | 361-771-6727
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 873044
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN311161
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License Number State | GA
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