Individual
NATHALIE KEARNS DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2911
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(617) 319-4417
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
181140
ME
207R00000X
Internal Medicine Physician
181140
ME
363LF0000X
Family Nurse Practitioner
Primary
CNP181140
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
181140
APP LICENSE
ME
01
—
72658
RN
ME
Enumeration date
11/06/2014
Last updated
08/16/2023
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