Healthcare Provider Details
I. General information
NPI: 1710408356
Provider Name (Legal Business Name): VIRGINIA LYDIA DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/05/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15 PRESTBURY SQ STE 14
NEWARK DE
19713-2608
US
IV. Provider business mailing address
15 PRESTBURY SQ STE 14
NEWARK DE
19713-2608
US
V. Phone/Fax
- Phone: 302-368-2273
- Fax: 302-368-2213
- Phone: 302-368-2273
- Fax: 302-368-2213
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC0400X |
| Taxonomy | Case Management Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC1500X |
| Taxonomy | Community Health Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC2100X |
| Taxonomy | Continence Care Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC3500X |
| Taxonomy | Cardiac Rehabilitation Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WD0400X |
| Taxonomy | Diabetes Educator Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WG0600X |
| Taxonomy | Gerontology Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WH0200X |
| Taxonomy | Home Health Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WI0600X |
| Taxonomy | Infection Control Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WM0102X |
| Taxonomy | Maternal Newborn Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WN1003X |
| Taxonomy | Nutrition Support Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0000X |
| Taxonomy | Pain Management Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0200X |
| Taxonomy | Pediatric Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WW0000X |
| Taxonomy | Wound Care Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WX1500X |
| Taxonomy | Ostomy Care Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
| # 15 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | L1-0019713 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
