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Individual

HEIDI L. DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
151 STATE ROUTE 10 E, STE 105, SUCCASUNNA, NJ 07876-1452
(973) 584-0002
(973) 584-7107
Mailing address
50 HILLCREST AVE, MONTVALE, NJ 07645-2228
(201) 505-9155
(973) 584-7104

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
26NJ00065300
NJ

Other

Enumeration date
01/23/2007
Last updated
07/08/2007
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