Provider Demographics
NPI:1124797154
Name:DAVIDSON, LINDA LEE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LEE
Last Name:DAVIDSON
Suffix:
Gender:
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 NW 57TH ST SUITE 10
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605
Mailing Address - Country:US
Mailing Address - Phone:352-474-8686
Mailing Address - Fax:
Practice Address - Street 1:919 NW 57TH ST STE 10
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-6437
Practice Address - Country:US
Practice Address - Phone:352-474-8686
Practice Address - Fax:352-364-4163
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9279902163WP2201X
FLAPRN11015454363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily