NPI 1750764932 · live from the CMS NPI Registry
Kathleen Davis, NP-C
Nurse Practitioner, Family in Canton, GA. National Provider Identifier 1750764932, active.
NPI record
| NPI | 1750764932 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 120 Oakside Ct, Canton, GA 30114 |
| Practice phone | 678-880-8770 |
| Mailing address | 2765 Lawrence Mill Run, Marietta, GA 30068 |
| Enumerated | July 7, 2015 |
| Last updated | October 21, 2020 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Diabetes Educator | 163WD0400X | RN068065 (GA) |
| Nurse Practitioner, Family primary | 363LF0000X | RN068065 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.