Provider Demographics
NPI:1245521665
Name:DAVIDSON, SHEILA DARLENE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:DARLENE
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:965 RIDGE LAKE BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9401
Mailing Address - Country:US
Mailing Address - Phone:877-348-1281
Mailing Address - Fax:901-227-3206
Practice Address - Street 1:1704 23RD AVENUE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301
Practice Address - Country:US
Practice Address - Phone:601-485-5081
Practice Address - Fax:601-553-6176
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2025-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MSR699691363L00000X
MS699691363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner