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NPI Code Detail

MEDICARE: JOYCE B DAVIDSON WHNP

MEDICARE: JOYCE B DAVIDSON WHNP
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
1174400000XSpecialistRN075897AZ
2363LW0102XWomen's Health Nurse PractitionerAP0009AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2RN075897OTHERAZSTATE LICENSE

General Provider Information

NPI Number : 1205817251
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOYCE B DAVIDSON WHNP
Provider Business Mailing Address
First Line : PO BOX 3630
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86003-3630
Country : US
Telephone Number : 928-233-5110
Fax Number : 928-774-6687
Provider Business Practice Location Address
First Line : 2920 N 4TH ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-1816
Country : US
Telephone Number : 928-213-6100
Fax Number : 928-774-4808
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 10/21/2013

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