Kellie Davidson, LVN
Individual provider Active NPI Licensed Vocational Nurse · Winchester, CA
NPI 1306297601 · NPPES record last updated Jun 29, 2024
Key facts
- NPI
- 1306297601
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Vocational Nurse 164X00000X
- License
- 684225 (CA)
- Practice address
- 33187 Skyview Rd
Winchester, CA 92596-4524 - Phone
- (248) 613-5082
- NPI assigned
- Jun 28, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95197565 | CA | MD | Registered Nurse |
| 684225 | CA | MD | Licensed Vocational Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 95197565 | CA | |
| Licensed Vocational Nurse | 164X00000X | 684225 | CA | Yes |
Addresses
Primary practice location
33187 Skyview Rd
Winchester, CA 92596-4524
Mailing address
33187 Skyview Rd
Winchester, CA 92596-4524
Phone (248) 613-5082
Other providers in Winchester, CA
- Cameron Leigh Cordle
- Tracy Crockett
- Stephanie Culpepper
- Diana Dandrea
- Keyana W Davenport
- Tricia A Dayon
- Denise W De la Riva
- Dental Corporation of Kyle Poulsen
- Alicia Dilley
- Doulas of California
All providers in Winchester, CA · Licensed Vocational Nurse in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.