TULLY BOOTH DAVIS (NPI# 1629676747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629676747 |
| Entity Type | Individual |
| Full Name | TULLY BOOTH DAVIS |
| Practice Address |
705 Emerald Dr Prattville AL 36067-3711 |
| Practice Telephone | 2052498551 |
| Mailing Telephone | 2052498551 |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-10-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD | EIB901379535 | 01 |
| Street Address |
705 EMERALD DR |
| City | PRATTVILLE |
| State | AL |
| Zip Code | 36067-3711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316352552 | Agape Me LLC | Case Manager/Care Coordinator | 353 Bent Tree Dr., Prattville, AL 36067 | 2014-06-26 |
| 1770868671 | Susan Elizabeth Swink | Pharmacist | 703 South Memorial Dr, Walgreens Pharmacy, Prattville, AL 36067 | 2011-10-12 |
| 1255501458 | Edwin R. Mullins | Dentist | 268 1st St., Prattville, AL 36067 | 2008-03-04 |
| 1598891046 | James Ronald Roberson Sr. | Dentist | 113 E Main, Prattville, AL 36067 | 2007-02-26 |
| 1326184029 | Prattville Primary Care LLC | Family Medicine | 461 E Main Street, Prattville, AL 36067 | 2007-01-29 |
| 1669591418 | Walter Eugene Parker | Family Medicine | 107 Quail Run, Prattville, AL 36067 | 2007-03-29 |
| 1376582049 | James Daniel Cartwright | Internal Medicine | 808 Durden Rd, Prattville, AL 36067-1533 | 2006-06-06 |
| 1386162816 | Logan Elizabeth Dodd | Speech-Language Pathologist | 815 Durden Rd, Prattville, AL 36067-1534 | 2017-09-05 |
| 1891182200 | Steve Weedon | Specialist/Technologist | 1218 Kingston Garden Rd, Prattville, AL 36067-1704 | 2015-04-23 |
| 1780042887 | James K Nichols Jr. | Nurse Anesthetist, Certified Registered | 101 Coleman Dr, Prattville, AL 36067-1766 | 2016-02-03 |
| Find all providers in zip 36067 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154716066 | Ashley Champion | Student in an Organized Health Care Education/Training Program | 199 Ridgewood Rd, Prattville, AL 36067-1913 | 2015-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679170823 | Terri Kast | Student in an Organized Health Care Education/Training Program | 2826 Moody Pkwy Ste A, Moody, AL 35004-3101 | 2020-10-01 |
| 1891302907 | Dyneisha Barrett | Student in an Organized Health Care Education/Training Program | 2251 Liberty Ct, Mobile, AL 36608-9145 | 2020-09-23 |
| 1174135966 | Amberlyn Nicole Baker | Student in an Organized Health Care Education/Training Program | 5370 Elgin Dr W, Grand Bay, AL 36541-3272 | 2020-08-21 |
| 1548872344 | Shelby Glynn | Student in an Organized Health Care Education/Training Program | 1200 Somerby Dr Apt 326, Mobile, AL 36695-5429 | 2020-08-21 |
| 1407468689 | Yasmeen Antheana-neshaygreen Brenson | Student in an Organized Health Care Education/Training Program | 206 Lakeview Ave, Selma, AL 36703-1705 | 2020-08-19 |
| 1366054496 | Marc Simon | Student in an Organized Health Care Education/Training Program | 7866 Taylor Park Rd Apt G, Montgomery, AL 36117-4769 | 2020-08-19 |
| 1982216388 | Kaitlyn Culotta Dozier | Student in an Organized Health Care Education/Training Program | 936 Grant Park Drive, Mobile, AL 36606 | 2020-08-18 |
| 1912518549 | Makenzie Rose-lynn Dunning | Student in an Organized Health Care Education/Training Program | 2841 Leigh Ct, Mobile, AL 36695-9794 | 2020-08-17 |
| 1093326613 | Rachael Lauren Abroms | Student in an Organized Health Care Education/Training Program | 871 W Briar Ct, Mobile, AL 36609-5167 | 2020-08-17 |
| 1669083275 | Amedee Stokley | Student in an Organized Health Care Education/Training Program | 25 Lancaster Rd, Mobile, AL 36608-1903 | 2020-08-17 |
| Find all providers with the same taxonomy | ||||
| City | PRATTVILLE |
| Zip Code | 36067 |
Please comment or provide details below to improve the information on TULLY BOOTH DAVIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.