Healthcare Provider Details

I. General information

NPI: 1295645695
Provider Name (Legal Business Name): ANNE DAVOUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNE HO

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 CHARLES ST
BOSTON MA
02114-3002
US

IV. Provider business mailing address

243 CHARLES ST
BOSTON MA
02114-3002
US

V. Phone/Fax

Practice location:
  • Phone: 617-573-3992
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2308546
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: