Individual
CAROLYN FAY DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, PMHNP
Contact information
Practice address
10242 BLUEMOUND RD, MILWAUKEE, WI 53226
(414) 301-7744
(414) 873-1385
Mailing address
10424 W BLUEMOUND RD, MILWAUKEE, WI 53226-4331
(414) 774-1704
(414) 873-1385
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
110303-030
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6526-33
WI
Other
Enumeration date
07/20/2009
Last updated
08/12/2015
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