Individual
MARISSA DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10710 CHARTER DR STE G020, COLUMBIA, MD 21044-3257
(410) 964-2122
Mailing address
10710 CHARTER DR STE G020, COLUMBIA, MD 21044-3257
(410) 964-2122
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R240305
MD
Other
Enumeration date
06/06/2024
Last updated
07/11/2024
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