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Individual

VIRGINIA DAVIDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN124479
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
267918
AZ

Other

Enumeration date
03/12/2019
Last updated
01/31/2022
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