Provider Demographics
NPI:1972128072
Name:DAVIS, CONNER NOELLE (AUD)
Entity Type:Individual
Prefix:
First Name:CONNER
Middle Name:NOELLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9430 PARK WEST BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4203
Mailing Address - Country:US
Mailing Address - Phone:865-693-6065
Mailing Address - Fax:865-531-6325
Practice Address - Street 1:9430 PARK WEST BLVD STE 330
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4203
Practice Address - Country:US
Practice Address - Phone:865-693-6065
Practice Address - Fax:865-531-6325
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4148237600000X
TN2067237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter