Individual
DEIRDRE A DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
1140 ROUTE 72 W, MANAHAWKIN, NJ 08050
(609) 597-6011
Mailing address
PO BOX 307, NEPTUNE, NJ 07754-0307
(732) 897-0263
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
356194
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
26NJ00224100
NJ
367500000X
Certified Registered Nurse Anesthetist
356194-1
NY
Other
Enumeration date
06/27/2005
Last updated
02/22/2019
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