Jennifer Larue Davitt, CRNFA
Individual provider Active NPI Registered Nurse First Assistant · Martin, GA
NPI 1528113370 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1528113370
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse First Assistant 163WR0006X
- License
- RN147341 (GA)
- Practice address
- 709 Wilson Rd
Martin, GA 30557-3573 - Phone
- (706) 244-1067
- Fax
- (888) 874-3544
- NPI assigned
- Jan 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN147341 | GA | MD | Registered Nurse First Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Whitley, LLC | Registered Nurse First Assistant | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse First Assistant | 163WR0006X | RN147341 | GA | Yes |
Addresses
Primary practice location
709 Wilson Rd
Martin, GA 30557-3573
Mailing address
709 Wilson Rd
Martin, GA 30557-3573
Phone (706) 244-1067
Other providers in Martin, GA
- Compass Home Care LLC
- Karen S.P. Eschedor
- Estatohe Counseling
- Justin Ludwig Ludwig
- Terry Morris
- Jaime Neill
All providers in Martin, GA · Registered Nurse First Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.