Provider Demographics
NPI:1164266755
Name:DAVIDSHOFER, ANN
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:DAVIDSHOFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 EVERETT CT
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:IA
Mailing Address - Zip Code:52253-7600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:60 EVERETT CT
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:IA
Practice Address - Zip Code:52253-7600
Practice Address - Country:US
Practice Address - Phone:319-361-2411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA099817163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse