Provider Demographics
NPI:1750021333
Name:DAVIDSON, CARRIE DEANN (EDD, ACSM EP)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:DEANN
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:EDD, ACSM EP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WESTGATE CT
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-9557
Mailing Address - Country:US
Mailing Address - Phone:859-533-0155
Mailing Address - Fax:
Practice Address - Street 1:55 WESTGATE CT
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-9557
Practice Address - Country:US
Practice Address - Phone:859-533-0155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist