Individual
PEGGY J DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
455 RICE RD STE 108, #108, TYLER, TX 75703-3604
(903) 939-0799
(903) 939-0799
Mailing address
108 FENTON RD, LONGVIEW, TX 75604-1119
(903) 939-0799
(903) 939-0799
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
249499
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175568801
—
TX
Enumeration date
08/09/2006
Last updated
08/12/2008
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