MEDICARE: ANNA M DAVIS NP

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
1	363L00000X	Nurse Practitioner	AC002156	MD
2	363L00000X	Nurse Practitioner	AP4397	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1528389038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA M DAVIS NP

Provider Business Mailing Address
First Line	:	9910 FRANKLIN SQUARE DR
Second Line	:	# 2110
City	:	BALTIMORE
State	:	MD
Zip	:	21236-4902
Country	:	US
Telephone Number	:	602-674-6575
Fax Number	:	602-674-6773

Provider Business Practice Location Address
First Line	:	8620 N 22ND AVE
Second Line	:	STE 200
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4251
Country	:	US
Telephone Number	:	202-877-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2010
Last Update Date	:	02/09/2018

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Directions to “ ANNA M DAVIS NP” Practice Location

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