Individual
STEPHANIE LYNN DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9127 W RUSSELL RD STE 110, LAS VEGAS, NV 89148-1253
(702) 878-0070
(702) 209-2064
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(702) 878-0070
(702) 209-2064
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
982
NV
207L00000X
Anesthesiology Physician
Primary
T3455
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2018612
—
NV
Enumeration date
01/26/2006
Last updated
12/14/2021
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