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NPI Code Detail

MEDICARE: MS. DEBORAH ANN DAVIDSON WOODS PNP

MEDICARE: MS. DEBORAH ANN DAVIDSON WOODS PNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner139550MO
2363LP0200XPediatric Nurse PractitionerX331266CA

General Provider Information

NPI Number : 1174799464
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBORAH ANN DAVIDSON WOODS PNP
Provider Business Mailing Address
First Line : 2279 45TH ST STE 1246
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-1514
Country : US
Telephone Number : 916-734-4899
Fax Number : 916-456-4501
Provider Business Practice Location Address
First Line : 2279 45TH ST STE 1246
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-1514
Country : US
Telephone Number : 916-734-4899
Fax Number : 916-456-4501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2008
Last Update Date : 10/27/2017

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