Healthcare Provider Details

I. General information

NPI: 1124944467
Provider Name (Legal Business Name): NAKITA D DAVIDSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 FOREST AVE
BUFFALO NY
14213-1207
US

IV. Provider business mailing address

400 FOREST AVE
BUFFALO NY
14213-1207
US

V. Phone/Fax

Practice location:
  • Phone: 716-885-2261
  • Fax: 716-816-2450
Mailing address:
  • Phone: 716-885-2261
  • Fax: 716-816-2450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number981405-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: