Individual
ANITA RENEE DAVIDSON COE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1389 DANTE ROAD, ST. PAUL, VA 24283-3658
(276) 762-0770
(276) 546-9711
Mailing address
PO BOX 2377, 495 EAST MAIN STREET, LEBANON, VA 24266-2377
(276) 889-3700
(276) 889-5505
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
00241717177
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024171717
DEPARTMENT OF HEALTH PROFESSIONS
VA
Enumeration date
06/18/2014
Last updated
09/29/2014
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