Provider Demographics
NPI:1801265368
Name:DAVIDSON, CHRISTINE MARGARET (FNP-BC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARGARET
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 LOCH CARRON WAY
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-5797
Mailing Address - Country:US
Mailing Address - Phone:571-437-8512
Mailing Address - Fax:
Practice Address - Street 1:1407 LOCH CARRON WAY
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-5797
Practice Address - Country:US
Practice Address - Phone:571-437-8512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR198598363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily