Individual
MS. MARYELLEN ANN DAVISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
140 BRIDGE ST, CLEVELAND, NY 13042-3144
(315) 675-3172
(315) 675-3018
Mailing address
140 BRIDGE ST, CLEVELAND, NY 13042-3144
(315) 675-3172
(315) 675-3018
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
358624-1
NY
Other
Enumeration date
03/01/2012
Last updated
03/01/2012
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