Provider Demographics
NPI:1912115031
Name:DAVISON, CAROL (RN, MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:DAVISON
Suffix:
Gender:F
Credentials:RN, MSN, FNP-C
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 829766
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-9766
Mailing Address - Country:US
Mailing Address - Phone:866-470-6626
Mailing Address - Fax:413-599-0470
Practice Address - Street 1:274 S ORANGE AVE FL 3
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2419
Practice Address - Country:US
Practice Address - Phone:973-732-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR07141500163W00000X
NJ26NN07141500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse