Provider Demographics
NPI:1558016758
Name:DAVIS, MIRANDA GREER (WHNP)
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:GREER
Last Name:DAVIS
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 LOVEJOY RD
Mailing Address - Street 2:
Mailing Address - City:ASHVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35953-5865
Mailing Address - Country:US
Mailing Address - Phone:256-295-8706
Mailing Address - Fax:
Practice Address - Street 1:2817 30TH AVE N
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35207-4541
Practice Address - Country:US
Practice Address - Phone:205-407-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-169000363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health