MEDICARE: ELEANOR DAVIS

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	R258483	MD

General Provider Information

NPI Number	:	1750252664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELEANOR DAVIS

Provider Business Mailing Address
First Line	:	9512 HARFORD RD STE 4
Second Line	:
City	:	PARKVILLE
State	:	MD
Zip	:	21234-3127
Country	:	US
Telephone Number	:	410-665-4400
Fax Number	:

Provider Business Practice Location Address
First Line	:	9512 HARFORD RD STE 4
Second Line	:
City	:	PARKVILLE
State	:	MD
Zip	:	21234-3127
Country	:	US
Telephone Number	:	410-665-4400
Fax Number	:

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

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	10/02/2025

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Directions to “ ELEANOR DAVIS ” Practice Location

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