Provider Demographics
NPI:1073269783
Name:DAVIS, PATTI ANNE (CCRP)
Entity Type:Individual
Prefix:MS
First Name:PATTI
Middle Name:ANNE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CCRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 NEW YORK ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-5822
Mailing Address - Country:US
Mailing Address - Phone:901-335-4519
Mailing Address - Fax:
Practice Address - Street 1:259 UNIVERSITY CTR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38152-3460
Practice Address - Country:US
Practice Address - Phone:901-678-2380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program