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Individual

MARY M DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1508 K V RD, VICTORIA, VA 23974-2624
(434) 696-2165
(434) 696-1557
Mailing address
1508 K V RD, VICTORIA, VA 23974-2624
(434) 696-2165
(434) 696-1557

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0001190763
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007691084
VA
Enumeration date
08/13/2007
Last updated
02/10/2022
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