MEDICARE: MS. CATHERINE ANASTASIA DAVIS RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	DN-0011197	DE

General Provider Information

NPI Number	:	1003705146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHERINE ANASTASIA DAVIS RD

Provider Business Mailing Address
First Line	:	964 GLACKENS LN
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19808-1128
Country	:	US
Telephone Number	:	302-256-2221
Fax Number	:

Provider Business Practice Location Address
First Line	:	964 GLACKENS LN
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19808-1128
Country	:	US
Telephone Number	:	302-256-2221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2025
Last Update Date	:	07/02/2025

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