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General NPI Number Information
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NPI Number | 1023655214
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Entity Type | Individual
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Provider Name | CHRISTIAN DAVIDSON
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Gender | Male
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Dates
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Enumeration Date | 12/06/2019
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 3111 SPURR RD
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City | LEXINGTON
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State | KY
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Zip | 40511-9000
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Country | US
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Telephone | 859-246-2366
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Fax |
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Provider Business Mailing Address
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Address Line | 226 TANNER CIR
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City | STANFORD
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State | KY
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Zip | 40484-8117
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Country | US
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Telephone | 606-669-0213
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3016476
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License Number State | KY
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