Provider Demographics
NPI:1104300185
Name:DAVIDSON, ANN-MARIE (APRN)
Entity type:Individual
Prefix:MS
First Name:ANN-MARIE
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20494
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-0494
Mailing Address - Country:US
Mailing Address - Phone:352-515-0025
Mailing Address - Fax:352-515-0174
Practice Address - Street 1:13141 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5016
Practice Address - Country:US
Practice Address - Phone:352-515-0025
Practice Address - Fax:813-406-4691
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9184976363LF0000X
FLAPRN9184976363LF0000X
FLRN9184976363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily