Individual
MIRIAM A DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
11 BAXTER BLVD FL 2, PORTLAND, ME 04101-1801
(603) 883-0005
Mailing address
11 BAXTER BLVD FL 2, PORTLAND, ME 04101-1801
(603) 883-0005
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
25621.1033RX
WY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP131085
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25621.1033RX
PSYCHIATRIC NURSE PRACTIONNER
WY
Enumeration date
05/05/2010
Last updated
02/19/2025
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