Provider Demographics
NPI:1942639687
Name:DAVIDSON, KATHERINE (RN)
Entity Type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 TIMBERLINE CT
Mailing Address - Street 2:
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-5775
Mailing Address - Country:US
Mailing Address - Phone:907-247-7688
Mailing Address - Fax:
Practice Address - Street 1:3208 TIMBERLINE CT
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-5775
Practice Address - Country:US
Practice Address - Phone:907-247-7688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK26474163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse