Provider Demographics
NPI:1083887160
Name:CHEELY-DAVIS, CATHERINE LYNN (RN)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:LYNN
Last Name:CHEELY-DAVIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 MISTY RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-3394
Mailing Address - Country:US
Mailing Address - Phone:404-626-3559
Mailing Address - Fax:678-610-4188
Practice Address - Street 1:1331 MISTY RIDGE CT
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-3394
Practice Address - Country:US
Practice Address - Phone:404-626-3559
Practice Address - Fax:678-610-4188
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN118305163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse