Provider Demographics
NPI:1487197505
Name:DAVIS, ANASTASIA CHEFON (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:CHEFON
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17931 HIGHWAY 67
Mailing Address - Street 2:APT 802
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-2300
Mailing Address - Country:US
Mailing Address - Phone:404-416-5028
Mailing Address - Fax:
Practice Address - Street 1:1497 FAIR RD STE 104
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-0822
Practice Address - Country:US
Practice Address - Phone:912-486-1600
Practice Address - Fax:912-871-3342
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN229035363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily