=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255605606
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHEL HUGHES DAVIDSON DNP, FNP-BC, CRNA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/02/2012
-----------------------------------------------------
Last Update Date | 03/06/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3104 BLUE LAKE DR SUITE 110
-----------------------------------------------------
City | VESTAVIA
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35243-2345
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-977-1949
-----------------------------------------------------
Fax | 205-977-1933
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3104 BLUE LAKE DR SUITE 110
-----------------------------------------------------
City | VESTAVIA
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35243-2345
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-977-1949
-----------------------------------------------------
Fax | 205-977-1933
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number | 3007342
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------