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Individual

MRS. LINDA L DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
319 S MANNING BLVD STE 106, ALBANY, NY 12208-1743
(518) 438-1019
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
332843
NY
363LF0000X
Family Nurse Practitioner
F332843
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02565933
NY
Enumeration date
07/04/2006
Last updated
05/11/2021
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