Provider Demographics
NPI:1912179136
Name:DAVISON, DOROTHY MARYANNE (FNP)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:MARYANNE
Last Name:DAVISON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 READ BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-3103
Mailing Address - Country:US
Mailing Address - Phone:504-245-7951
Mailing Address - Fax:504-245-7935
Practice Address - Street 1:5501 READ BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-3103
Practice Address - Country:US
Practice Address - Phone:504-245-7951
Practice Address - Fax:504-245-7935
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000058450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily