Individual
NANCY D DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
12301 GRAPEFIELD RD, BASTIAN, VA 24314-4547
(276) 688-4331
(276) 688-4336
Mailing address
PO BOX 423, ANAWALT, WV 24808-0423
(304) 383-2594
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
33507
WV
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
2021101359
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104800671
—
VA
05
—
7104188000
—
WV
Enumeration date
09/30/2005
Last updated
06/06/2023
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