Individual
MELISSA B DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
207 SPARKS AVE, SUITE 403, JEFFERSONVILLE, IN 47130-3739
(812) 288-9141
(812) 288-1023
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 559-9337
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28160307A
IN
363LF0000X
Family Nurse Practitioner
Primary
28160307A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201339720
—
IN
01
—
IN446560
MEDICARE
IN
Enumeration date
09/28/2014
Last updated
04/04/2024
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