MEDICARE: MARIA DAVIS CRNP

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	363LF0000X	Family Nurse Practitioner	SP021215	PA

General Provider Information

NPI Number	:	1699326413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA DAVIS CRNP

Provider Business Mailing Address
First Line	:	1002 CHEROKEE ST
Second Line	:
City	:	FOUNTAIN HILL
State	:	PA
Zip	:	18015-4115
Country	:	US
Telephone Number	:	610-597-0363
Fax Number	:

Provider Business Practice Location Address
First Line	:	1490 8TH AVE STE 130
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18018-2212
Country	:	US
Telephone Number	:	484-884-8146
Fax Number	:

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

Provider Enumeration Date	:	09/23/2019
Last Update Date	:	12/22/2025

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