| NPI | 1649480864 |
|---|---|
| Former Name | HEATHER JEAN DAVIDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NJ00152200) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN570491) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP009606) | |
| 163W00000X Registered Nurse (Licence: NJ 26NR12877800) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-02-02 |