Provider Demographics
NPI:1760511059
Name:DAVIDSON, LAURA LEE (CRNP, CNM)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LEE
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:CRNP, CNM
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:SETLIFF
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP,CNM
Mailing Address - Street 1:503 KING FARM BLVD
Mailing Address - Street 2:#208
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6600
Mailing Address - Country:US
Mailing Address - Phone:202-288-8664
Mailing Address - Fax:
Practice Address - Street 1:503 KING FARM BLVD
Practice Address - Street 2:#208
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6600
Practice Address - Country:US
Practice Address - Phone:202-288-8664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR123190363LF0000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife