Provider Demographics
NPI:1306990262
Name:DAVIS, VONDA LEEANN (FNP)
Entity type:Individual
Prefix:MS
First Name:VONDA
Middle Name:LEEANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 363
Mailing Address - Street 2:710 HWY 51 BYPASS
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024
Mailing Address - Country:US
Mailing Address - Phone:731-286-4300
Mailing Address - Fax:731-286-8008
Practice Address - Street 1:1950 COOK STREET
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024
Practice Address - Country:US
Practice Address - Phone:731-286-4300
Practice Address - Fax:731-286-8008
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN6152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily