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Individual

STACY DAVIDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP-AC

Contact information

Practice address
2315 STOCKTON BLVD, SACRAMENTO, CA 95817-2201
(916) 734-9200
Mailing address
2432 MEADOWLARK CIR, WEST SACRAMENTO, CA 95691-4628
(507) 360-9625

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95003179
CA

Other

Enumeration date
06/02/2021
Last updated
10/13/2021
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