Individual
DESIREE MARIE DAVISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHA-T
Contact information
Practice address
1000 GREG KRUSHEK AVE, NOME, AK 99762-9976
(907) 890-3311
(907) 890-2280
Mailing address
P.O. BOX 69, ELIM, AK 99739-0069
(907) 890-3311
(907) 890-2280
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHA-T
CHA-T
AK
Enumeration date
08/27/2021
Last updated
08/27/2021
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