Provider Demographics
NPI:1609550672
Name:DAVIDSON, DORIS ANN
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:ANN
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 10TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-3608
Mailing Address - Country:US
Mailing Address - Phone:828-480-0234
Mailing Address - Fax:
Practice Address - Street 1:219 10TH AVE SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-3608
Practice Address - Country:US
Practice Address - Phone:828-480-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide