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Tyra Davenport
NPI 1740567759 · on the registry since 2011
Practice
- Address
- 4004 N Church St
Greensboro, NC 27455 - Phone
- (336) 686-3226
- Organisation at this address
- Tyra Davenport Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 101YP2500X
101YP2500X
- Also registered as
- 101Y00000X
101YM0800X - Licence states on file
- NC
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2011-11-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in North Carolina