Provider Demographics
NPI:1528105459
Name:WEBB-DAVIDSON, AMANDA SHARON (PA-C)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:SHARON
Last Name:WEBB-DAVIDSON
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:788 ROUTE 45
Mailing Address - Street 2:
Mailing Address - City:PILESGROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:08098-2803
Mailing Address - Country:US
Mailing Address - Phone:856-241-2227
Mailing Address - Fax:856-241-2110
Practice Address - Street 1:300 LEXINGTON RD STE 220
Practice Address - Street 2:SUITE 220 BUILDING B
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-1278
Practice Address - Country:US
Practice Address - Phone:856-241-2227
Practice Address - Fax:856-241-2110
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2010-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP0011600363A00000X
MDCO4086363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant