Healthcare Provider Details

I. General information

NPI: 1982914677
Provider Name (Legal Business Name): DEEANNE DAVIS M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 04/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 SUNNY ISLE ISLAND MEDICAL CENTER ST 301
CHRISTIANSTED VI
00820
US

IV. Provider business mailing address

PO BOX 26152 GALLOWSBAY STN.
CHRISTIANSTED VI
00824-2152
US

V. Phone/Fax

Practice location:
  • Phone: 340-719-0690
  • Fax:
Mailing address:
  • Phone: 408-569-0281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: