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Individual
JENNIFER LYNN DAVIDSON
Active
Individual
JENNIFER LYNN DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
125288
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0159608
—
IA
01
—
07466
WELLMARK BCBS
IA
Enumeration date
07/01/2013
Last updated
07/01/2013
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