Davis, Shelly Denice

Davis, Shelly Denice is an individual health care provider with primary practice located at 612 Love Avenue , Tifton GA 31794. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Davis, Shelly Denice can be contacted via phone (229) 391-3300.

Contact Information

Primary practice address
612 Love Avenue Tifton GA 31794
Phone: (229) 391-3300
Fax: (229) 388-1948
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN089222 Georgia

Profile Details

NPI number 1386805885
LBN Legal business name Davis, Shelly Denice
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2008
Last updated Jun 13th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386805885 NPPES
Georgia MEDICAID 481466728A

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