Individual
DEIDRA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1243 WASHINGTON BLVD, BALTIMORE, MD 21230-1826
(443) 717-7345
Mailing address
1243 WASHINGTON BLVD, BALTIMORE, MD 21230
(443) 717-7345
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
A00084709
MD
Other
Enumeration date
08/04/2010
Last updated
08/04/2010
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