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General NPI Number Information
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NPI Number | 1730762345
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Entity Type | Individual
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Provider Name | JENNIFER DAVIDSON
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Gender | Female
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Dates
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Enumeration Date | 05/01/2021
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 2525 S TELSHOR BLVD STE 15-202
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City | LAS CRUCES
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State | NM
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Zip | 88011-5071
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Country | US
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Telephone | 888-209-8874
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Fax |
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Provider Business Mailing Address
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Address Line | 87 N LOAFER CANYON RD
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City | ELK RIDGE
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State | UT
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Zip | 84651-8546
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Country | US
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Telephone | 801-360-7316
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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 | CRXN.0100777-C-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 300299
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 286329-4405
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95028560
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 77758
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License Number State | NM
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