Provider Demographics
NPI:1861515918
Name:DAVENPORT, BARBARA JEAN
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JEAN
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 CHOWAN SHORES DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLERAIN
Mailing Address - State:NC
Mailing Address - Zip Code:27924
Mailing Address - Country:US
Mailing Address - Phone:252-209-6986
Mailing Address - Fax:
Practice Address - Street 1:116 CHOWAN SHORES DRIVE
Practice Address - Street 2:
Practice Address - City:COLERAIN
Practice Address - State:NC
Practice Address - Zip Code:27924
Practice Address - Country:US
Practice Address - Phone:252-209-6986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging