ASHLEY COOPER-DAVENPORT AAC
Nursing Yellow Pages
Gainesville, Georgia
Provider NPI: 1922054824
Provider Information:ASHLEY COOPER-DAVENPORT AAC
Practice Location:
743 SPRING ST NE GAINESVILLE, GA 30501 US
Tel: 770-532-7179 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 367H00000X | Physician Assistants & Advanced Practice Nursing Providers Anesthesiologist Assistant | GA | 003718 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
206182101A | GA | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin