Individual
ANGELINE MARIE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592-1645
(434) 517-3100
Mailing address
3340 SHIPLEY ST APT 1404, LADSON, SC 29456-4173
(804) 339-5260
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
124554
SC
Other
Enumeration date
02/01/2019
Last updated
01/23/2020
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