Provider Demographics
NPI:1710212535
Name:VOSS, DAVEDA C (NP)
Entity Type:Individual
Prefix:MS
First Name:DAVEDA
Middle Name:C
Last Name:VOSS
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:630 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:IL
Mailing Address - Zip Code:62321-1459
Mailing Address - Country:US
Mailing Address - Phone:217-357-2173
Mailing Address - Fax:217-357-3610
Practice Address - Street 1:630 LOCUST ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:IL
Practice Address - Zip Code:62321-1459
Practice Address - Country:US
Practice Address - Phone:217-357-2173
Practice Address - Fax:217-357-3610
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL041.228009163WP0000X
IL209.007703363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0000XNursing Service ProvidersRegistered NursePain Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209.007703OtherSTATE LICENSE