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General NPI Number Information
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NPI Number | 1356755276
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Entity Type | Individual
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Provider Name | ANITA RENEE DAVIDSON COE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 09/29/2014
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Provider Practice Location Address
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Address Line | 1389 DANTE ROAD
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City | ST. PAUL
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State | VA
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Zip | 24283-3658
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Country | US
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Telephone | 276-762-0770
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Fax | 276-546-9711
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Provider Business Mailing Address
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Address Line | PO BOX 2377 495 EAST MAIN STREET
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City | LEBANON
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State | VA
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Zip | 24266-2377
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Country | US
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Telephone | 276-889-3700
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Fax | 276-889-5505
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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 | 00241717177
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License Number State | VA
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