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General NPI Number Information
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NPI Number | 1871808014
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Entity Type | Individual
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Provider Name | ANNETTA DELORES DAVIS APN,C
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Gender | Female
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 06/06/2013
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Provider Practice Location Address
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Address Line | 1401 ROUTE 70 E SUITE #1
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City | CHERRY HILL
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State | NJ
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Zip | 08034-2207
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Country | US
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Telephone | 856-429-7600
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Fax | 609-429-7130
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Provider Business Mailing Address
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Address Line | 73 JENNIFER LN
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City | BURLINGTON TOWNSHIP
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State | NJ
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Zip | 08016-1145
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Country | US
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Telephone | 609-386-1080
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Fax | 609-386-1080
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ00299600
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License Number State | NJ
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