Mary Elaine Davia, CRNP

Individual provider Active NPI Family Nurse Practitioner · Marriottsville, MD

NPI 1750367140 · NPPES record last updated Apr 28, 2011

Key facts

NPI
1750367140
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
R043216 (MD)
Practice address
1515A Marriottsville Rd
Marriottsville, MD 21104-1301
Phone
(410) 442-2079
NPI assigned
Dec 19, 2005
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)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R043216MDMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R043216 MD Yes

Addresses

Primary practice location

1515A Marriottsville Rd
Marriottsville, MD 21104-1301

Mailing address

1515A Marriottsville Rd
Marriottsville, MD 21104-1301
Phone (410) 442-2079

Other providers in Marriottsville, MD

All providers in Marriottsville, MD · Family Nurse Practitioner in Maryland

Sources for this page

Verify at the official NPI Registry.