Most Relevant Information
Provider Data
| NPI Number: | 1003812819 |
| Provider Name: | DEIRDRE A DAVIS C.R.N.A. |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | 356194 |
Most Important Dates
| Enumeration Date: | 06/27/2005 |
| Last Updated: | 02/22/2019 |
Provider Practice Location
1140 ROUTE 72 W
MANAHAWKIN
NJ
08050
Practice Location Phone/Fax
| Phone: | 6095976011 |
| Fax: |
Provider Mailing Location
PO BOX 307
NEPTUNE
NJ
077540307
Provider Mailing Phone/Fax
| Phone: | |
| Fax: | 7328970263 |