Individual
NITA VIANN RANDOLPH DAVISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1889 S SYCAMORE ST, PETERSBURG, VA 23805-2730
(804) 605-9845
(804) 895-7853
Mailing address
1889 S SYCAMORE ST, PETERSBURG, VA 23805-2730
(804) 605-9845
(804) 895-7853
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
05/14/2014
Last updated
11/14/2023
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