Healthcare Provider Details

I. General information

NPI: 1124797154
Provider Name (Legal Business Name): LINDA LEE DAVIDSON NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 NW 57TH ST STE 10
GAINESVILLE FL
32605-6437
US

IV. Provider business mailing address

919 NW 57TH ST SUITE 10
GAINESVILLE FL
32605
US

V. Phone/Fax

Practice location:
  • Phone: 352-474-8686
  • Fax: 352-364-4163
Mailing address:
  • Phone: 352-474-8686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN9279902
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11015454
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11015454
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: