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General NPI Number Information
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NPI Number | 1902550387
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Entity Type | Individual
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Provider Name | ANDREA TANNEH DAVIES PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/04/2022
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 2 INDUSTRIAL PARK DR STE C
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City | WALDORF
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State | MD
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Zip | 20602-2729
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Country | US
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Telephone | 301-792-7207
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Fax |
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Provider Business Mailing Address
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Address Line | 6205 KILDARE CT
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City | FORT WASHINGTON
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State | MD
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Zip | 20744-1969
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Country | US
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Telephone | 240-389-7222
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP1035938
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License Number State | DC
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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 | R227019
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R227019
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN1035938
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License Number State | DC
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