MEDICARE: ANN ELIZABETH DAVISON RN MSN

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	163W00000X	Registered Nurse	069422	IA

General Provider Information

NPI Number	:	1740485382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN ELIZABETH DAVISON RN MSN

Provider Business Mailing Address
First Line	:	2005 ASBURY RD
Second Line	:
City	:	DUBUQUE
State	:	IA
Zip	:	52001-3042
Country	:	US
Telephone Number	:	563-583-7357
Fax Number	:	563-583-7026

Provider Business Practice Location Address
First Line	:	745 PEPPER DR
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-4332
Country	:	US
Telephone Number	:	319-341-9849
Fax Number	:

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

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	07/08/2007

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