Provider Demographics
NPI:1477144459
Name:DAVIS, ABIGAIL G (APRN)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:G
Last Name:DAVIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 QUAIL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COTTONTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37048-9665
Mailing Address - Country:US
Mailing Address - Phone:615-319-8856
Mailing Address - Fax:
Practice Address - Street 1:491 SAGE RD N STE 800
Practice Address - Street 2:
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188-9362
Practice Address - Country:US
Practice Address - Phone:615-672-4089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28905363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner