Healthcare Provider Details

I. General information

NPI: 1750939112
Provider Name (Legal Business Name): ARIELLE DAVIDSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2696
US

IV. Provider business mailing address

82 ATHERTON RD APT 1
BROOKLINE MA
02446-2769
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-5130
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2318081
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberRN2318081
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN2318081
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: