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NPI Code Detail

MEDICARE: MICHELE R DAVIDSON PMHNP

MEDICARE: MICHELE R DAVIDSON PMHNP
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
12084P0800XPsychiatry Physician0024146903VA

General Provider Information

NPI Number : 1487782538
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE R DAVIDSON PMHNP
Provider Business Mailing Address
First Line : 1545 CROSSWAYS BLVD STE 250
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23320-0218
Country : US
Telephone Number : 757-992-9600
Fax Number : 757-432-3211
Provider Business Practice Location Address
First Line : 1545 CROSSWAYS BLVD STE 250
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23320-0218
Country : US
Telephone Number : 757-992-9600
Fax Number : 757-432-3211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 03/11/2021

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