Individual
LIDIA ELIZABETH DAVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1417 MADISON PARK DR, GLEN BURNIE, MD 21061-5613
(410) 768-6600
(410) 768-3132
Mailing address
1417 MADISON PARK DR, GLEN BURNIE, MD 21061-5613
(410) 768-6600
(410) 768-3132
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN1019874
DC
363LA2100X
Acute Care Nurse Practitioner
RN1019874
DC
364SA2100X
Acute Care Clinical Nurse Specialist
Primary
R198453
MD
Other
Enumeration date
03/08/2016
Last updated
10/24/2023
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