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General NPI Number Information
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NPI Number | 1265292957
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Entity Type | Individual
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Provider Name | MARSHA DAVIDSON
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Gender | Female
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Dates
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Enumeration Date | 03/20/2024
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR
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City | LEBANON
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State | NH
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Zip | 03756-0001
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Country | US
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Telephone | 603-650-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 91 ROUTE 12A
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City | PLAINFIELD
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State | NH
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Zip | 03781-5081
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Country | US
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Telephone | 813-760-1636
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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 | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 078149-23
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 078149-23
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License Number State | NH
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